A Computerized Decision Support System (CDSS) for Antibiotic Prescription in Primary Care\textemdashAntibioclic: Implementation, Adoption and Sustainable Use in the Era of Extended Antimicrobial Resistance - Sorbonne Université Access content directly
Journal Articles Journal of Antimicrobial Chemotherapy Year : 2020

A Computerized Decision Support System (CDSS) for Antibiotic Prescription in Primary Care\textemdashAntibioclic: Implementation, Adoption and Sustainable Use in the Era of Extended Antimicrobial Resistance

Abstract

Abstract Objectives To describe the implementation and use of a computerized decision support system (CDSS) for antibiotic prescription in primary care in France (Antibioclic). The CDSS targets 37 infectious diseases and has been freely available on a website since 2011. Methods Description and implementation of the architecture of a CDSS for antibiotic prescription in general practice. Analysis of the queries made between 2012 and 2018 on the CDSS by GPs. Analysis of two cross-sectional studies of users in 2014 and 2019. Results The number of queries increased from a median of 796/day [IQR, 578\textendash 989] in 2012 to 11\,125/day [5592\textendash 12\,505] in 2018. Unique users increased from 414/day [245\textendash 494] in 2012 to 5365/day [2891\textendash 5769] in 2018. Time taken to make a query was 2\,min [1.9\textendash 2.1]. Among 3\,542\,347 queries in 2018, 78% were for adults. Six situations accounted for ≥q50% of queries: cystitis; acute otitis media; acute sinusitis; community-acquired pneumonia; sore throat; and pyelonephritis. Queries concerned pathologies for which antibiotic prescription was necessary (64%), was conditional on additional clinical steps (34%) or was not recommended (2%). Most users (81%) were GPs, with median age of 38\,years [31\textendash 52] and 58% were female. Among the 4016 GPs who responded to the surveys, the vast majority (96%) reported using the CDSS during the consultation, with 24% systematically using Antibioclic to initiate an antibiotic course and 93% having followed the CDSS recommendation for the latest prescription. Most GPs were comfortable using the CDSS in front of a patient. Conclusions Antibioclic has been adopted and is widely used in primary care in France. Its interoperability could allow its adaptation and implementation in other countries.
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Dates and versions

hal-03888699 , version 1 (30-01-2023)

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Tristan Delory, Pauline Jeanmougin, Sylvie Lariven, Jean-Pierre Aubert, Nathan Peiffer-Smadja, et al.. A Computerized Decision Support System (CDSS) for Antibiotic Prescription in Primary Care\textemdashAntibioclic: Implementation, Adoption and Sustainable Use in the Era of Extended Antimicrobial Resistance. Journal of Antimicrobial Chemotherapy, 2020, pp.dkaa167. ⟨10.1093/jac/dkaa167⟩. ⟨hal-03888699⟩
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