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The effect of adding a mobile health intervention to a multimodal antimicrobial stewardship programme across three teaching hospitals – an interrupted time series study

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Title: The effect of adding a mobile health intervention to a multimodal antimicrobial stewardship programme across three teaching hospitals – an interrupted time series study
Authors: Charani, E
Gharbi, M
Moore, LSP
Castro Sanchez, E
Lawson, W
Gilchrist, M
Holmes, AH
Item Type: Journal Article
Abstract: Objectives To evaluate the impact of adding a mobile health (mHealth) decision support system for antibiotic prescribing to an established antimicrobial stewardship programme (ASP). Methods In August 2011, the antimicrobial prescribing policy was converted into a mobile application (app). A segmented regression analysis of interrupted time series was used to assess the impact of the app on prescribing indicators using data (2008-2014) from a biannual point prevalence study (PPS) in medicine and surgery wards. There were six data points pre and six data points post-implementation. Results There was an increase in compliance with policy (e.g. compliance with empirical therapy or expert advice) in medicine (6.48%, CI -1.25—14.20) and surgery (6.63%, CI 0.15—13.10) in the implementation period, with a significant sudden change in level in surgery (p<0.05). There was an increase, though not significant, in medicine (15.20%, CI 17.81—48.22) and surgery (35.97%, -3.72—75.66) in the percentage of prescriptions that had a stop/review date documented. The documentation of indication decreased in both medicine (-16.25%, CI -42.52—10.01) and surgery (-14.62%, CI -42.88—13.63). Conclusion Introducing the ‘app’ to an existing ASP had a significant impact on the compliance to policy in surgery, and a positive but not significant effect on documentation of stop/review date in both specialties. The negative effect on the third indicator may have been due to existing ASP efforts. The broader value of providing an antimicrobial policy on a digital platform e.g. the reach and access to the policy, should be measured using indicators more sensitive to mHealth interventions.
Issue Date: 28-Feb-2017
Date of Acceptance: 20-Jan-2017
URI: http://hdl.handle.net/10044/1/44311
DOI: https://dx.doi.org/10.1093/jac/dkx040
ISSN: 1460-2091
Publisher: Oxford University Press (OUP)
Start Page: 1825
End Page: 1831
Journal / Book Title: Journal of Antimicrobial Chemotherapy
Volume: 72
Issue: 6
Copyright Statement: © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Sponsor/Funder: Helse Bergen HF
Helse Bergen HF
National Institute for Health Research
National Institute for Health Research
Funder's Grant Number: 3827176
3827176
HPRU-2012-10047
HPRU-2012-10047
Keywords: Microbiology
1115 Pharmacology And Pharmaceutical Sciences
0605 Microbiology
1108 Medical Microbiology
Publication Status: Published
Appears in Collections:Department of Medicine
Faculty of Medicine



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