The development and implementation of a guideline-based clinical decision support system to improve empirical antibiotic prescribing

H. Akhloufi*, H. van der Sijs, D. C. Melles, C. P. van der Hoeven, M. Vogel, J. W. Mouton, A. Verbon

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Scopus)
25 Downloads (Pure)

Abstract

Background: To describe and evaluate a clinical decision support system (CDSS) for empirical antibiotic therapy using a systematic framework. Methods: A reporting framework for behavior change intervention implementation was used, which includes several domains: development, evaluation and implementation. Within the development domain a description is given of the engagement of stakeholders, a rationale for how the CDSS may influence antibiotic prescribing and a detailed outline of how the system was developed. Within the evaluation domain a technical validation is performed and the interaction between potential users and the CDSS is analyzed. Within the domain of implementation a description is given on how the CDSS was tested in the real world and the strategies that were used for implementation and adoption of the CDSS. Results: Development: a CDSS was developed, with the involvement of stakeholders, to assist empirical antibiotic prescribing by physicians. Evaluation: Technical problems were determined during the validation process and corrected in a new CDSS version. A usability study was performed to assess problems in the system-user interaction. Implementation: In 114 patients the antibiotic advice that was generated by the CDSS was followed. For 54 patients the recommendations were not adhered to. Conclusions: This study describes the development and validation of a CDSS for empirical antibiotic therapy and shows the usefulness of the systematic framework for reporting CDSS interventions. In addition it shows that CDSS recommendations are not always adhered to which is associated with incorrect use of the system.

Original languageEnglish
Article number127
JournalBMC Medical Informatics and Decision Making
Volume22
Issue number1
DOIs
Publication statusPublished - 10 May 2022

Bibliographical note

Funding Information:
This work was supported by the Netherlands Organization for Health Research and Development (ZonMW) (Grant No. 836021021).

Publisher Copyright: © 2022, The Author(s).

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