Impact of integrating guidelines into an antimicrobial stewardship smartphone application on outpatient antibiotic prescribing: a segmented interrupted time series analysis.

IF 3.2 Q1 HEALTH CARE SCIENCES & SERVICES
Frontiers in digital health Pub Date : 2025-09-16 eCollection Date: 2025-01-01 DOI:10.3389/fdgth.2025.1647528
Ahmed A Sadeq, Laila Z Alhaj Ali, Jinan M Shamseddine, Barbara R Conway, Stuart E Bond, Rizwan Ali, William J Lattyak, Zahir Osman Eltahir Babiker, Mamoon A Aldeyab
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引用次数: 0

Abstract

Introduction: Antimicrobial stewardship (AMS) smartphone applications (apps) have been adopted to promote better antimicrobial prescribing practices. We aimed to evaluate the impact of incorporating an app on AMS metrics and adherence to a local antimicrobial guideline in an outpatient setting.

Methods: A quasi-experimental, segmented interrupted time series design was used, involving three study phases (pre-intervention: 1st January 2020 to 31st December 2021; implementation: 1st January 2022 to 31st December 2022, and post-intervention: 1st January 2023 to 30th June 2024) in a hospital outpatient setting. The effect of introducing an AMS app incorporating local antimicrobial guidelines on AMS outcomes was measured.

Results: A total of 24,424 patients were identified. As per the most simple model, the amounts of the following antibiotics, expressed as defined daily dose (DDD) per 100 patient visits, increased significantly during the post-intervention phase: azithromycin (co-efficient 0.297, p = 0.007), co-amoxiclav (co-efficient 2.608, p = 0.042), and nitrofurantoin (co-efficient 0.908, p = 0.003). The trend in fosfomycin use decreased significantly in the post-intervention phase (co-efficient -0.23., p < 0.001). Guideline adherence increased significantly after implementing the AMS app (trend change co-efficient 0.011, p < 0.001). These changes in antibiotic prescribing represent improved guideline adherence, and are aligned with WHO AWaRe categorisation recommendations.

Conclusion: The app improved the utilization of antibiotic prescribing by increasing adherence to local antimicrobial guidelines, affirming its utility in augmenting AMS in outpatient settings.

将指南整合到抗菌药物管理智能手机应用程序对门诊抗生素处方的影响:分段中断时间序列分析。
导言:抗菌素管理(AMS)智能手机应用程序(应用程序)已被采用,以促进更好的抗菌素处方实践。我们的目的是评估在门诊环境中纳入应用程序对AMS指标和遵守当地抗菌指南的影响。方法:采用准实验、分段中断时间序列设计,涉及三个研究阶段(干预前:2020年1月1日至2021年12月31日;实施:2022年1月1日至2022年12月31日;干预后:2023年1月1日至2024年6月30日),在一家医院门诊环境中进行。引入AMS应用程序结合当地抗菌指南对AMS结果的影响进行了测量。结果:共发现24,424例患者。根据最简单的模型,在干预后阶段,以每100例患者就诊的定义日剂量(DDD)表示的抗生素数量显著增加:阿奇霉素(系数0.297,p = 0.007)、共阿莫昔拉夫(系数2.608,p = 0.042)和呋喃托因(系数0.908,p = 0.003)。干预后阶段磷霉素使用趋势显著下降(系数-0.23)。结论:该应用程序通过提高对当地抗菌指南的依从性,提高了抗生素处方的利用率,肯定了其在门诊环境中增加AMS的效用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.20
自引率
0.00%
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0
审稿时长
13 weeks
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