Health Information Management Research Centre, Department of Health Information Management & Technology, Kashan University of Medical Sciences, Kashan, Iran.
Health Information Management Research Centre, Department of Health Information Management & Technology, Kashan University of Medical Sciences, Kashan, Iran.
Clin Microbiol Infect. 2021 Jun;27(6):838-845. doi: 10.1016/j.cmi.2021.03.030. Epub 2021 Apr 1.
Information technology (IT) interventions provide physicians with easy and quick access to information at the point of care and can play a major role in clinical decision-making for antibiotic prescribing. This study aimed to examine the effects and characteristics of IT interventions on improving antibiotic prescribing for patients with acute respiratory infection (ARI).
A comprehensive search was performed in Medline (through PubMed), ISI web of science, Embase, and Cochrane databases from inception to 31 August 2020. Randomized controlled trial (RCT) and cluster RCT (CRCT) studies examining the effectiveness of IT interventions in improving antibiotic prescribing for patients with ARI were included. Participants were patients with ARI. IT interventions were used for improving antibiotic prescribing. Two researchers independently extracted data from studies on methods, characteristics of interventions, and results. The characteristics of interventions were extracted based on three dimensions of IT design, data entry source, and implementation characteristics.
Eighteen studies (15 CRCTs and three RCTs) were included. Most of included studies (n = 11) were conducted in the United States. In 12 studies (66.7%), IT interventions improved the level of antibiotic prescribing, and in eight of the 12 studies the effect was statistically significant. In two studies the intervention had a statistically significant negative effect, and in two studies the level of antibiotic prescribing was not changed. Seventeen studies (94.4%) used clinical decision support systems (CDSSs) for the intervention. In 12 studies (66.7%) CDSSs were integrated with electronic health records (EHRs).
Information technology interventions have the potential to improve prescription of antibiotics for patients with acute respiratory infection and to change physicians' behaviours in this regard. Factors affecting the acceptance of IT-based interventions to improve prescription of antibiotics should be investigated in future studies.
信息技术（IT）干预措施为医生在护理点提供了便捷、快速的信息获取途径，在抗生素处方决策中发挥着重要作用。本研究旨在考察 IT 干预措施在改善急性呼吸道感染（ARI）患者抗生素处方方面的效果和特点。
从建库至 2020 年 8 月 31 日，我们在 Medline（通过 PubMed）、ISI web of science、Embase 和 Cochrane 数据库中进行了全面检索。纳入研究包括评估 IT 干预措施在改善 ARI 患者抗生素处方效果的随机对照试验（RCT）和整群 RCT（CRCT）。研究对象为 ARI 患者，干预措施用于改善抗生素处方。两位研究者独立提取研究方法、干预措施特点和结果数据。干预措施特点基于 IT 设计的三个维度、数据录入来源和实施特点提取。
纳入 18 项研究（15 项 CRCT 和 3 项 RCT）。纳入研究大多（n=11）来自美国。12 项研究（66.7%）中 IT 干预措施提高了抗生素处方水平，其中 8 项研究的效果具有统计学意义。两项研究的干预措施具有统计学意义的负效应，两项研究抗生素处方水平未发生改变。17 项研究（94.4%）采用临床决策支持系统（CDSS）进行干预，12 项研究（66.7%）中 CDSS 与电子健康记录（EHR）集成。
IT 干预措施具有改善 ARI 患者抗生素处方的潜力，并能改变医生在这方面的行为。未来的研究应调查影响接受基于 IT 的干预措施以改善抗生素处方的因素。
