PDF(Pubmed)
Abstract：
Mobile health platforms like smartphone apps that provide clinical guidelines are ubiquitous, yet their long-term impact on guideline adherence remains unclear. In 2016, an antibiotic guidelines app, called SCRIPT, was introduced in Auckland City Hospital, New Zealand, to provide local antibiotic guidelines to clinicians on their smartphones.
We aimed to assess whether the provision of antibiotic guidelines in a smartphone app resulted in sustained changes in antibiotic guideline adherence by prescribers.
We analyzed antibiotic guideline adherence rates during the first 24 hours of hospital admission in adults diagnosed with community-acquired pneumonia using an interrupted time-series study with 3 distinct periods post app implementation (ie, 3, 12, and 24 months).
Adherence increased from 23% (46/200) at baseline to 31% (73/237) at 3 months and 34% (69/200) at 12 months, reducing to 31% (62/200) at 24 months post app implementation (P=.07 vs baseline). However, increased adherence was sustained in patients with pulmonary consolidation on x-ray (9/63, 14% at baseline; 23/77, 30% after 3 months; 32/92, 35% after 12 month; and 32/102, 31% after 24 months; P=.04 vs baseline).
An antibiotic guidelines app increased overall adherence, but this was not sustained. In patients with pulmonary consolidation, the increased adherence was sustained.
We aimed to assess whether the provision of antibiotic guidelines in a smartphone app resulted in sustained changes in antibiotic guideline adherence by prescribers.
We analyzed antibiotic guideline adherence rates during the first 24 hours of hospital admission in adults diagnosed with community-acquired pneumonia using an interrupted time-series study with 3 distinct periods post app implementation (ie, 3, 12, and 24 months).
Adherence increased from 23% (46/200) at baseline to 31% (73/237) at 3 months and 34% (69/200) at 12 months, reducing to 31% (62/200) at 24 months post app implementation (P=.07 vs baseline). However, increased adherence was sustained in patients with pulmonary consolidation on x-ray (9/63, 14% at baseline; 23/77, 30% after 3 months; 32/92, 35% after 12 month; and 32/102, 31% after 24 months; P=.04 vs baseline).
An antibiotic guidelines app increased overall adherence, but this was not sustained. In patients with pulmonary consolidation, the increased adherence was sustained.
摘要：
背景：提供临床指南的智能手机应用程序等移动健康平台无处不在，然而,它们对指南依从性的长期影响尚不清楚.2016年，抗生素指南应用程序，叫做SCRIPT，是在奥克兰市医院介绍的，新西兰,在智能手机上向临床医生提供当地抗生素指南。
目的：我们旨在评估在智能手机应用中提供抗生素指南是否导致处方者对抗生素指南依从性的持续改变。
方法：我们使用中断的时间序列研究分析了被诊断患有社区获得性肺炎的成年人在入院的前24小时内的抗生素指南依从率（即，3、12和24个月）。
结果：依从性从基线时的23%（46/200）增加到3个月时的31%（73/237）和12个月时的34%（69/200），在应用实施后24个月减少到31%（62/200）（P=.07与基线相比）。然而,在X线检查时,肺实变患者的依从性持续增加(基线时9/63,14%;3个月后23/77,30%;12个月后32/92,35%;24个月后32/102,31%;与基线相比P=.04).
结论：抗生素指南应用程序提高了总体依从性，但这并没有持续下去。在肺实变患者中，坚持的增加是持续的。
目的：我们旨在评估在智能手机应用中提供抗生素指南是否导致处方者对抗生素指南依从性的持续改变。
方法：我们使用中断的时间序列研究分析了被诊断患有社区获得性肺炎的成年人在入院的前24小时内的抗生素指南依从率（即，3、12和24个月）。
结果：依从性从基线时的23%（46/200）增加到3个月时的31%（73/237）和12个月时的34%（69/200），在应用实施后24个月减少到31%（62/200）（P=.07与基线相比）。然而,在X线检查时,肺实变患者的依从性持续增加(基线时9/63,14%;3个月后23/77,30%;12个月后32/92,35%;24个月后32/102,31%;与基线相比P=.04).
结论：抗生素指南应用程序提高了总体依从性，但这并没有持续下去。在肺实变患者中，坚持的增加是持续的。
