CDS system helps to curb inappropriate prescribing

Study of primary care practices finds broad use of antibiotics for acute respiratory infections declines with the technology's use

Use of an electronic health record clinical decision support system to prescribe antibiotics for patients suffering from acute respiratory infections helps to ensure the appropriateness of those prescriptions, a study recently published online in the Journal of General Internal Medicine concludes.

For the study, nine primary care practices within the Practice Partner Research Network (PPRNet)--a practice-based research organization based at the Medical University of South Carolina in Charleston--participated in a two-phase, 27-month long demonstration pilot in which the practices used a common EHR CDSS that targeted multiple factors. The researchers found that use of broad spectrum antibiotics for acute respiratory infections--sinusitis, in particular--declined by slightly more than 16 percent for both adults and children.

The CDSS was used more than 38,500 times throughout the 27-month long program; 39 providers, in all, participated.

The researchers concluded that the intervention "shows promise for promoting judicious antibiotic use" in primary care settings; they hypothesized that antibiotic overuse has lead to the "emergence of antibiotic resistant bacteria, creating a public health problem."

"Because multiple factors contribute to a provider's decision to prescribe antibiotics for ARIs, including awareness of prescribing guidelines, perceived patient expectations, uncertainty of diagnosis and concern for potential complications, single component interventions only marginally impact prescribing behaviors," the researchers wrote.

Retrospective research of EHRs published in the Annals of Internal Medicine in August came to a similar conclusion. In that study, the more cases a doctor had for context of an illness, the less likely he or she was to assume that a prescription was the right course of action.

To learn more:
- here's the JGIM abstract

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