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Funded by the NIHR School for Primary Care Research, researchers at the Universities of Bristol, Oxford, Nottingham and Southampton, have completed the recruitment of patients onto the Oral Steroids for Acute Cough (OSAC) trial.

“Thanks to the efforts of GP practice staff from Lancaster to Torbay, NIHR staff across the UK and all collaborators and research team, we achieved 398 participants (not counting two baseline withdrawals),” said Harriet Downing, OSAC Trial Manager from the Centre for Academic Primary Care at Bristol. “We have obtained our first primary outcome for 90% of these participants, and the second primary outcome for 94%. So even though we did not obtain the original recruitment target (436), we have more than compensated for this in the quality of our follow-up, giving us real confidence that we will be able to answer the research question with 90% power.”

The final numbers, by centre, are: Bristol (232), Oxford (84), Southampton (44), Nottingham (38).

The project tests the hypothesis that oral corticosteroids tablets (prednisolone) can reduce the duration of moderately bad or worse cough, and the severity of the unpleasant symptoms associated with a lower respiratory tract infection (LRTI).

LRTI is one of the most common conditions managed in UK primary care and costs an estimated £200m per year in NHS consultations and antibiotic prescriptions. Antibiotics continue to be heavily prescribed for LRTI, even though it is known that they are not effective in treating uncomplicated cases, and several other studies of potential alternative treatments have not come up with strong evidence of effectiveness. The OSAC team is looking for a clinically relevant difference in cough duration and/or symptom severity of at least 20%. If steroids do prove clinically effective, the team will also assess how cost-effective they could be as a potential alternative future treatment option.

More news from the Centre for Academic Primary Care (CAPC) at the University of Bristol.

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