Improved paediatric antimicrobial prescribing with a smartphone application: a before and after interventional study.

Autor:	Primhak S; Paediatric Infectious Diseases, Starship Children's Health, Auckland, New Zealand sprimhak@adhb.govt.nz.; Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand., Pool N; Antimicrobial Stewardship Pharmacist, Starship Children's Health, Auckland, New Zealand.; Paediatrics, Middlemore Hospital, Auckland, New Zealand., Sam MSY; Paediatric Infectious Diseases, Starship Children's Health, Auckland, New Zealand., Duffy E; Antimicrobial Stewardship Pharmacist, Auckland City Hospital, Auckland, New Zealand., Ritchie SR; Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.; Infectious Diseases, Auckland City Hospital, Auckland, New Zealand., Webb R; Paediatric Infectious Diseases, Starship Children's Health, Auckland, New Zealand.; Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.; Paediatrics, Middlemore Hospital, Auckland, New Zealand., Wilson E; Paediatric Infectious Diseases, Starship Children's Health, Auckland, New Zealand., Voss L; Paediatric Infectious Diseases, Starship Children's Health, Auckland, New Zealand., Best EJ; Paediatric Infectious Diseases, Starship Children's Health, Auckland, New Zealand.; Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Jazyk:	angličtina
Zdroj:	Archives of disease in childhood [Arch Dis Child] 2023 Nov; Vol. 108 (11), pp. 899-903. Date of Electronic Publication: 2023 Jul 18.
DOI:	10.1136/archdischild-2023-325795
Abstrakt:	Introduction: Children have a high consumption of antimicrobials that require complicated decision-making by prescribers. Despite this, antimicrobial stewardship (AMS) interventions are often not translated into paediatric medicine. Script is a smartphone application (app) launched in Auckland, New Zealand to support decision-making for antimicrobial prescribers. The aim was to improve adherence to existing local clinical guidelines for both adult and paediatric infections. Methods: Inpatient and emergency department antimicrobial prescriptions were prospectively collected and evaluated for guideline adherence. Baseline prescribing data were collected and compared with prescribing at 4 months and 1 year after the app was launched. Prescriptions were graded as 'appropriate' or 'inappropriate' by investigators. Grading was done blinded to timing of the prescription relative to the intervention. Results: Following the launch of the Script app, guideline adherence significantly increased from 241 of 348 (69%) antimicrobial prescriptions graded as appropriate during the baseline period to 301 of 359 (83%) after 4 months (p<0.0001). This improvement from baseline was sustained at 1 year with 263 of 323 (81%) adherence (p<0.001). At 1 year, this improvement could be demonstrated separately for medical, surgical and emergency department prescriptions. Conclusion: There was a significant and sustained improvement in adherence to paediatric antimicrobial guidelines following the introduction of a prescribing support app. The need to seek guidance for antimicrobial doses due to the age-based and weight-based calculations in paediatrics may mean that AMS interventions such as decision support and prescribing tools are particularly well suited to paediatric prescribing. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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