Improving Antibiotic Prescribing for Pneumonia with Computer Support
Author Information
Author(s): Kirsty L Buising, Karin A Thursky, James F Black, Lachlan MacGregor, Alan C Street, Marcus P Kennedy, Graham V Brown
Primary Institution: Royal Melbourne Hospital
Hypothesis
Does a computerised decision support system achieve more than academic detailing alone in improving antibiotic prescribing for community acquired pneumonia?
Conclusion
The use of a computerised decision support system led to better antibiotic prescribing practices than academic detailing alone.
Supporting Evidence
- The odds ratio for concordant therapy in the academic detailing period was OR = 2.79.
- The odds ratio for the computerised decision support period compared to the academic detailing period was OR = 1.99.
- Concordant antibiotic prescribing improved significantly during the computerised decision support period.
Takeaway
Doctors used a computer program to help them choose the right antibiotics for pneumonia, and it worked better than just talking to them about it.
Methodology
A time series analysis comparing antibiotic prescribing behavior over three periods: baseline, academic detailing, and computerised decision support.
Potential Biases
Potential bias due to the lack of randomization and the influence of time on prescribing behavior.
Limitations
The study did not include a separate control group and relied on the same clinicians at different time points.
Participant Demographics
Patients diagnosed with community acquired pneumonia in an urban adult tertiary teaching hospital.
Statistical Information
P-Value
p<0.01
Confidence Interval
[1.88, 4.14]
Statistical Significance
p<0.01
Digital Object Identifier (DOI)
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