Keywords
RECRUITMENT

Due to the need to rapidly implement the Germ Defence intervention during the COVID-19 pandemic, a novel efficient trial design was adopted, evaluating an active intervention across all GP practices in England.The paper outlines the efficient trial design, where no GP practice or patient recruitment was required, and GP practices were not required to send the research team any data, with all outcomes assessed using anonymous patient record data in situ via the OpenSAFELY trusted research environment and website analytics.