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一项即时医疗证据改善儿童中耳炎抗生素处方实践的随机对照试验。

A randomized controlled trial of point-of-care evidence to improve the antibiotic prescribing practices for otitis media in children.

作者信息

Christakis D A, Zimmerman F J, Wright J A, Garrison M M, Rivara F P, Davis R L

机构信息

Child Health Institute, University of Washington, Seattle, Washington, USA.

出版信息

Pediatrics. 2001 Feb;107(2):E15. doi: 10.1542/peds.107.2.e15.

Abstract

CONTEXT

Prescribing practices for otitis media are not consistent with current evidence-based recommendations.

OBJECTIVE

To determine whether point-of-care evidence delivery regarding the use and duration of antibiotics for otitis media decreases the duration of therapy from 10 days and decreases the frequency of prescriptions written.

DESIGN

Randomized, controlled trial.

SETTING

Primary care pediatric clinic affiliated with university training program. Intervention. A point-of-care evidence-based message system presenting real time evidence to providers based on their prescribing practice for otitis media.

MAIN OUTCOME MEASURES

Proportion of prescriptions for otitis media that were for <10 days and frequency with which antibiotics were prescribed.

RESULTS

Intervention providers had a 34% greater reduction in the proportion of time they prescribed antibiotics for <10 days. Intervention providers were less likely to prescribe antibiotics than were control providers.

CONCLUSIONS

A point-of-care information system integrated into outpatient pediatric care can significantly influence provider behavior for a common condition.

摘要

背景

中耳炎的处方做法与当前基于证据的建议不一致。

目的

确定关于中耳炎抗生素使用和疗程的即时护理证据传递是否能将治疗疗程从10天缩短,并减少处方开具频率。

设计

随机对照试验。

地点

附属大学培训项目的基层医疗儿科诊所。干预措施:一个即时护理循证信息系统,根据提供者对中耳炎的处方做法向其呈现实时证据。

主要观察指标

疗程少于10天的中耳炎处方比例以及抗生素的处方频率。

结果

干预组提供者开具疗程少于10天抗生素的时间比例降低了34%。与对照组提供者相比,干预组提供者开具抗生素的可能性更小。

结论

整合到门诊儿科护理中的即时护理信息系统可显著影响常见病症的提供者行为。

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