Implementation of an antibiotic stewardship clinical decision support tool and its impact on attitudes and behaviors towards antibiotic prescribing in a low-middle-income country
Background: Antimicrobial stewardship programs are limited in resources to provide real-time assistance with antibiotic prescribing in healthcare settings in low-middle-income countries. The potential of clinical decision support systems (CDSS) for improving antibiotic stewardship efforts in resourc...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-12-01
|
| Series: | Journal of Global Antimicrobial Resistance |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716524002662 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850251857268572160 |
|---|---|
| author | Nosheen Nasir Beenish Khalid Mehmood Safia Awan Saadia Sattar Salma Tajuddin Sonia Qureshi |
| author_facet | Nosheen Nasir Beenish Khalid Mehmood Safia Awan Saadia Sattar Salma Tajuddin Sonia Qureshi |
| author_sort | Nosheen Nasir |
| collection | DOAJ |
| description | Background: Antimicrobial stewardship programs are limited in resources to provide real-time assistance with antibiotic prescribing in healthcare settings in low-middle-income countries. The potential of clinical decision support systems (CDSS) for improving antibiotic stewardship efforts in resource-constrained settings is largely unexplored. Our study aims to assess physicians' attitudes and behaviors towards antibiotic prescribing, and the impact of a CDSS tool on prescribing practices at a tertiary care center in Karachi, Pakistan. METHODS: A cross-sectional pre and post-CDSS intervention survey was conducted among all physicians prescribing antibiotics and data was collected on a pre-tested questionnaire on antibiotic use, antimicrobial stewardship, and source of information. RESULTS: Of the 263 physicians who responded to the survey, 63.5% (n=167) were females and the majority 54.4% (n=142) were practicing medicine. 33.9% (89/263) of the physicians were unaware of the institutional antibiotic guidelines. 66% (111/168) were not satisfied with the current electronic pdf-based guideline format. Furthermore, 52.6% of physicians proposed that the availability of a mobile application would greatly enhance access to the guidelines. After the mhealth-based CDSS intervention (Figure 1) the accessibility of guidelines via mobile applications and the internet increased from 7.69% to 17.58% and 15.64% to 24.18% respectively. Additionally, there was an improvement in adherence to hospital guidelines from 29.6% to 31.65% (Figures 2 and 3). CONCLUSION: Our study identified barriers to resource utilization for appropriate antibiotic prescribing which led to the development of a local guideline-based clinical decision support system and resulted in better guideline adherence among the prescribing physicians. |
| format | Article |
| id | doaj-art-88fee866298c437cb19abfae484d6223 |
| institution | OA Journals |
| issn | 2213-7165 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj-art-88fee866298c437cb19abfae484d62232025-08-20T01:57:48ZengElsevierJournal of Global Antimicrobial Resistance2213-71652024-12-01392910.1016/j.jgar.2024.10.089Implementation of an antibiotic stewardship clinical decision support tool and its impact on attitudes and behaviors towards antibiotic prescribing in a low-middle-income countryNosheen Nasir0Beenish Khalid Mehmood1Safia Awan2Saadia Sattar3Salma Tajuddin4Sonia Qureshi5Department of Medicine, Aga Khan University, Karachi, PakistanDepartment of Medicine, Aga Khan University, Karachi, PakistanDepartment of Medicine, Aga Khan University, Karachi, PakistanDepartment of Medicine, Aga Khan University, Karachi, PakistanDepartment of Medicine, Aga Khan University, Karachi, PakistanDepartment of Paediatrics, Aga Khan University, Karachi, PakistanBackground: Antimicrobial stewardship programs are limited in resources to provide real-time assistance with antibiotic prescribing in healthcare settings in low-middle-income countries. The potential of clinical decision support systems (CDSS) for improving antibiotic stewardship efforts in resource-constrained settings is largely unexplored. Our study aims to assess physicians' attitudes and behaviors towards antibiotic prescribing, and the impact of a CDSS tool on prescribing practices at a tertiary care center in Karachi, Pakistan. METHODS: A cross-sectional pre and post-CDSS intervention survey was conducted among all physicians prescribing antibiotics and data was collected on a pre-tested questionnaire on antibiotic use, antimicrobial stewardship, and source of information. RESULTS: Of the 263 physicians who responded to the survey, 63.5% (n=167) were females and the majority 54.4% (n=142) were practicing medicine. 33.9% (89/263) of the physicians were unaware of the institutional antibiotic guidelines. 66% (111/168) were not satisfied with the current electronic pdf-based guideline format. Furthermore, 52.6% of physicians proposed that the availability of a mobile application would greatly enhance access to the guidelines. After the mhealth-based CDSS intervention (Figure 1) the accessibility of guidelines via mobile applications and the internet increased from 7.69% to 17.58% and 15.64% to 24.18% respectively. Additionally, there was an improvement in adherence to hospital guidelines from 29.6% to 31.65% (Figures 2 and 3). CONCLUSION: Our study identified barriers to resource utilization for appropriate antibiotic prescribing which led to the development of a local guideline-based clinical decision support system and resulted in better guideline adherence among the prescribing physicians.http://www.sciencedirect.com/science/article/pii/S2213716524002662Antibiotic StewardshipClinical Decision Support toolmhealth |
| spellingShingle | Nosheen Nasir Beenish Khalid Mehmood Safia Awan Saadia Sattar Salma Tajuddin Sonia Qureshi Implementation of an antibiotic stewardship clinical decision support tool and its impact on attitudes and behaviors towards antibiotic prescribing in a low-middle-income country Journal of Global Antimicrobial Resistance Antibiotic Stewardship Clinical Decision Support tool mhealth |
| title | Implementation of an antibiotic stewardship clinical decision support tool and its impact on attitudes and behaviors towards antibiotic prescribing in a low-middle-income country |
| title_full | Implementation of an antibiotic stewardship clinical decision support tool and its impact on attitudes and behaviors towards antibiotic prescribing in a low-middle-income country |
| title_fullStr | Implementation of an antibiotic stewardship clinical decision support tool and its impact on attitudes and behaviors towards antibiotic prescribing in a low-middle-income country |
| title_full_unstemmed | Implementation of an antibiotic stewardship clinical decision support tool and its impact on attitudes and behaviors towards antibiotic prescribing in a low-middle-income country |
| title_short | Implementation of an antibiotic stewardship clinical decision support tool and its impact on attitudes and behaviors towards antibiotic prescribing in a low-middle-income country |
| title_sort | implementation of an antibiotic stewardship clinical decision support tool and its impact on attitudes and behaviors towards antibiotic prescribing in a low middle income country |
| topic | Antibiotic Stewardship Clinical Decision Support tool mhealth |
| url | http://www.sciencedirect.com/science/article/pii/S2213716524002662 |
| work_keys_str_mv | AT nosheennasir implementationofanantibioticstewardshipclinicaldecisionsupporttoolanditsimpactonattitudesandbehaviorstowardsantibioticprescribinginalowmiddleincomecountry AT beenishkhalidmehmood implementationofanantibioticstewardshipclinicaldecisionsupporttoolanditsimpactonattitudesandbehaviorstowardsantibioticprescribinginalowmiddleincomecountry AT safiaawan implementationofanantibioticstewardshipclinicaldecisionsupporttoolanditsimpactonattitudesandbehaviorstowardsantibioticprescribinginalowmiddleincomecountry AT saadiasattar implementationofanantibioticstewardshipclinicaldecisionsupporttoolanditsimpactonattitudesandbehaviorstowardsantibioticprescribinginalowmiddleincomecountry AT salmatajuddin implementationofanantibioticstewardshipclinicaldecisionsupporttoolanditsimpactonattitudesandbehaviorstowardsantibioticprescribinginalowmiddleincomecountry AT soniaqureshi implementationofanantibioticstewardshipclinicaldecisionsupporttoolanditsimpactonattitudesandbehaviorstowardsantibioticprescribinginalowmiddleincomecountry |