Impact of a Computerized Template on Antibiotic Prescribing for Acute Respiratory Infections in Children and Adolescents
Background. Computerized decision support (CDS) can potentially improve patient safety and guideline adherence. The authors developed an acute respiratory illness interactive template (ARI-IT) within an electronic health record (EHR) to manage pediatric ARIs and assessed the impact on antibiotic pre...
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| Veröffentlicht in: | Clinical pediatrics 2010-10, Vol.49 (10), p.976-983 |
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| container_title | Clinical pediatrics |
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| creator | Bourgeois, Fabienne C. Linder, Jeffrey Johnson, Sarah A. Co, John Patrick T. Fiskio, Julie Ferris, Timothy G. |
| description | Background. Computerized decision support (CDS) can potentially improve patient safety and guideline adherence. The authors developed an acute respiratory illness interactive template (ARI-IT) within an electronic health record (EHR) to manage pediatric ARIs and assessed the impact on antibiotic prescribing. Methods. They randomized 12 practices either to receive the ARI-IT or to the control group. Antibiotic rates among all eligible ARI diagnoses were compared among control and intervention ARI visits, controlling for clustering by clinician. Results. There was no difference in total antibiotic prescriptions between control and intervention clinics. Use of the ARI-IT significantly reduced antibiotic prescriptions (31.7% vs 39.9%; P = .02) and use of macrolides (6.2% vs 9.5%; P = .02) among visits compared with those eligible visits where it was not used. Conclusion. Use of the CDS reduced antibiotic prescribing and macrolide prescriptions among children with an ARI. Nonetheless, the low overall use resulted in an ineffective intervention. |
| doi_str_mv | 10.1177/0009922810373649 |
| format | Article |
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Computerized decision support (CDS) can potentially improve patient safety and guideline adherence. The authors developed an acute respiratory illness interactive template (ARI-IT) within an electronic health record (EHR) to manage pediatric ARIs and assessed the impact on antibiotic prescribing. Methods. They randomized 12 practices either to receive the ARI-IT or to the control group. Antibiotic rates among all eligible ARI diagnoses were compared among control and intervention ARI visits, controlling for clustering by clinician. Results. There was no difference in total antibiotic prescriptions between control and intervention clinics. Use of the ARI-IT significantly reduced antibiotic prescriptions (31.7% vs 39.9%; P = .02) and use of macrolides (6.2% vs 9.5%; P = .02) among visits compared with those eligible visits where it was not used. Conclusion. Use of the CDS reduced antibiotic prescribing and macrolide prescriptions among children with an ARI. Nonetheless, the low overall use resulted in an ineffective intervention.</description><identifier>ISSN: 0009-9228</identifier><identifier>EISSN: 1938-2707</identifier><identifier>DOI: 10.1177/0009922810373649</identifier><identifier>PMID: 20724348</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Acute Disease ; Adolescent ; Adolescents ; Anti-Bacterial Agents - administration & dosage ; Antibiotics ; Child ; Children ; Drug Prescriptions - standards ; Electronic medical records ; Female ; Humans ; Macrolides - administration & dosage ; Male ; Medical Records Systems, Computerized - statistics & numerical data ; Medical Records Systems, Computerized - utilization ; Respiratory tract infection ; Respiratory Tract Infections - drug therapy ; Teenagers</subject><ispartof>Clinical pediatrics, 2010-10, Vol.49 (10), p.976-983</ispartof><rights>The Author(s) 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c364t-669d7e549c041b904aa9c34751de8f290c28b6b33a91d455a0f3892db80a6ccf3</citedby><cites>FETCH-LOGICAL-c364t-669d7e549c041b904aa9c34751de8f290c28b6b33a91d455a0f3892db80a6ccf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0009922810373649$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0009922810373649$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21818,27923,27924,43620,43621</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20724348$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bourgeois, Fabienne C.</creatorcontrib><creatorcontrib>Linder, Jeffrey</creatorcontrib><creatorcontrib>Johnson, Sarah A.</creatorcontrib><creatorcontrib>Co, John Patrick T.</creatorcontrib><creatorcontrib>Fiskio, Julie</creatorcontrib><creatorcontrib>Ferris, Timothy G.</creatorcontrib><title>Impact of a Computerized Template on Antibiotic Prescribing for Acute Respiratory Infections in Children and Adolescents</title><title>Clinical pediatrics</title><addtitle>Clin Pediatr (Phila)</addtitle><description>Background. Computerized decision support (CDS) can potentially improve patient safety and guideline adherence. The authors developed an acute respiratory illness interactive template (ARI-IT) within an electronic health record (EHR) to manage pediatric ARIs and assessed the impact on antibiotic prescribing. Methods. They randomized 12 practices either to receive the ARI-IT or to the control group. Antibiotic rates among all eligible ARI diagnoses were compared among control and intervention ARI visits, controlling for clustering by clinician. Results. There was no difference in total antibiotic prescriptions between control and intervention clinics. Use of the ARI-IT significantly reduced antibiotic prescriptions (31.7% vs 39.9%; P = .02) and use of macrolides (6.2% vs 9.5%; P = .02) among visits compared with those eligible visits where it was not used. Conclusion. Use of the CDS reduced antibiotic prescribing and macrolide prescriptions among children with an ARI. Nonetheless, the low overall use resulted in an ineffective intervention.</description><subject>Acute Disease</subject><subject>Adolescent</subject><subject>Adolescents</subject><subject>Anti-Bacterial Agents - administration & dosage</subject><subject>Antibiotics</subject><subject>Child</subject><subject>Children</subject><subject>Drug Prescriptions - standards</subject><subject>Electronic medical records</subject><subject>Female</subject><subject>Humans</subject><subject>Macrolides - administration & dosage</subject><subject>Male</subject><subject>Medical Records Systems, Computerized - statistics & numerical data</subject><subject>Medical Records Systems, Computerized - utilization</subject><subject>Respiratory tract infection</subject><subject>Respiratory Tract Infections - drug therapy</subject><subject>Teenagers</subject><issn>0009-9228</issn><issn>1938-2707</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1r3DAQxUVJabZJ7j0VQQ49udWXLem4LP1YCLSU9GxkaZwq2JIjydDtX18tm5YSyGkY5vfezPAQekPJe0ql_EAI0ZoxRQmXvBP6BdpQzVXDJJFnaHMcN8f5OXqd8z0hlJOWv0LnjEgmuFAb9Gs_L8YWHEds8C7Oy1og-d_g8C3My2QK4BjwNhQ_-Fi8xd8SZJtqF-7wGBPe2qrA3yEvPpkS0wHvwwi2-Bgy9gHvfvrJJQjYBIe3Lk5VDqHkS_RyNFOGq8d6gX58-ni7-9LcfP28321vGlsfKk3XaSehFdoSQQdNhDHaciFb6kCNTBPL1NANnBtNnWhbQ0auNHODIqazduQX6N3Jd0nxYYVc-tnXC6bJBIhr7mXbUkVZxyt5_YS8j2sK9bieaqY6KpTuKkVOlE0x5wRjvyQ_m3ToKemPofRPQ6mSt4_G6zCD-yf4m0IFmhOQzR38t_U5wz_rfZQW</recordid><startdate>201010</startdate><enddate>201010</enddate><creator>Bourgeois, Fabienne C.</creator><creator>Linder, Jeffrey</creator><creator>Johnson, Sarah A.</creator><creator>Co, John Patrick T.</creator><creator>Fiskio, Julie</creator><creator>Ferris, Timothy G.</creator><general>SAGE Publications</general><general>Westminster Publications, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7QR</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201010</creationdate><title>Impact of a Computerized Template on Antibiotic Prescribing for Acute Respiratory Infections in Children and Adolescents</title><author>Bourgeois, Fabienne C. ; Linder, Jeffrey ; Johnson, Sarah A. ; Co, John Patrick T. ; Fiskio, Julie ; Ferris, Timothy G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c364t-669d7e549c041b904aa9c34751de8f290c28b6b33a91d455a0f3892db80a6ccf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Acute Disease</topic><topic>Adolescent</topic><topic>Adolescents</topic><topic>Anti-Bacterial Agents - administration & dosage</topic><topic>Antibiotics</topic><topic>Child</topic><topic>Children</topic><topic>Drug Prescriptions - standards</topic><topic>Electronic medical records</topic><topic>Female</topic><topic>Humans</topic><topic>Macrolides - administration & dosage</topic><topic>Male</topic><topic>Medical Records Systems, Computerized - statistics & numerical data</topic><topic>Medical Records Systems, Computerized - utilization</topic><topic>Respiratory tract infection</topic><topic>Respiratory Tract Infections - drug therapy</topic><topic>Teenagers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bourgeois, Fabienne C.</creatorcontrib><creatorcontrib>Linder, Jeffrey</creatorcontrib><creatorcontrib>Johnson, Sarah A.</creatorcontrib><creatorcontrib>Co, John Patrick T.</creatorcontrib><creatorcontrib>Fiskio, Julie</creatorcontrib><creatorcontrib>Ferris, Timothy G.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bourgeois, Fabienne C.</au><au>Linder, Jeffrey</au><au>Johnson, Sarah A.</au><au>Co, John Patrick T.</au><au>Fiskio, Julie</au><au>Ferris, Timothy G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of a Computerized Template on Antibiotic Prescribing for Acute Respiratory Infections in Children and Adolescents</atitle><jtitle>Clinical pediatrics</jtitle><addtitle>Clin Pediatr (Phila)</addtitle><date>2010-10</date><risdate>2010</risdate><volume>49</volume><issue>10</issue><spage>976</spage><epage>983</epage><pages>976-983</pages><issn>0009-9228</issn><eissn>1938-2707</eissn><abstract>Background. Computerized decision support (CDS) can potentially improve patient safety and guideline adherence. The authors developed an acute respiratory illness interactive template (ARI-IT) within an electronic health record (EHR) to manage pediatric ARIs and assessed the impact on antibiotic prescribing. Methods. They randomized 12 practices either to receive the ARI-IT or to the control group. Antibiotic rates among all eligible ARI diagnoses were compared among control and intervention ARI visits, controlling for clustering by clinician. Results. There was no difference in total antibiotic prescriptions between control and intervention clinics. Use of the ARI-IT significantly reduced antibiotic prescriptions (31.7% vs 39.9%; P = .02) and use of macrolides (6.2% vs 9.5%; P = .02) among visits compared with those eligible visits where it was not used. Conclusion. Use of the CDS reduced antibiotic prescribing and macrolide prescriptions among children with an ARI. Nonetheless, the low overall use resulted in an ineffective intervention.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>20724348</pmid><doi>10.1177/0009922810373649</doi><tpages>8</tpages></addata></record> |
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| subjects | Acute Disease Adolescent Adolescents Anti-Bacterial Agents - administration & dosage Antibiotics Child Children Drug Prescriptions - standards Electronic medical records Female Humans Macrolides - administration & dosage Male Medical Records Systems, Computerized - statistics & numerical data Medical Records Systems, Computerized - utilization Respiratory tract infection Respiratory Tract Infections - drug therapy Teenagers |
| title | Impact of a Computerized Template on Antibiotic Prescribing for Acute Respiratory Infections in Children and Adolescents |
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