Use of stewardship smartphone applications by physicians and prescribing of antimicrobials in hospitals: A systematic review.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
17
06
2020
accepted:
11
09
2020
entrez:
29
9
2020
pubmed:
30
9
2020
medline:
15
12
2020
Statut:
epublish
Résumé
Antimicrobial stewardship (AMS) programs promote appropriate use of antimicrobials and reduce antimicrobial resistance. Technological developments have resulted in smartphone applications (apps) facilitating AMS. Yet, their impact is unclear. Systematically review AMS apps and their impact on prescribing by physicians treating in-hospital patients. EMBASE, MEDLINE (Ovid), Cochrane Central, Web of Science and Google Scholar. Studies focusing on smartphone or tablet apps and antimicrobial therapy published from January 2008 until February 28th 2019 were included. Physicians treating in-hospital patients. AMS apps. Systematic review. Thirteen studies met the eligibility criteria. None was a randomized controlled trial. Methodological study quality was considered low to moderate in all but three qualitative studies. The primary outcomes were process indicators, adherence to guidelines and user experience. Guidelines were more frequently accessed by app (53.0% - 89.6%) than by desktop in three studies. Adherence to guidelines increased (6.5% - 74.0%) significantly for several indications after app implementation in four studies. Most users considered app use easy (77.4%->90.0%) and useful (71.0%->90%) in three studies and preferred it over guideline access by web viewer or booklet in two studies. However, some physicians regarded app use adjacent to colleagues or patients unprofessional in three qualitative studies. Susceptibility to several antimicrobials changed significantly post-intervention (from 5% decrease to 10% - 14% increase) in one study. Use of AMS apps seems to promote access to and knowledge of antimicrobial prescribing policy, and increase adherence to guidelines in hospitals. However, this has been assessed in a limited number of studies and for specific indications. Good quality studies are necessary to properly assess the impact of AMS apps on antimicrobial prescribing. To improve adherence to antimicrobial guidelines, use of AMS apps could be considered.
Sections du résumé
BACKGROUND
Antimicrobial stewardship (AMS) programs promote appropriate use of antimicrobials and reduce antimicrobial resistance. Technological developments have resulted in smartphone applications (apps) facilitating AMS. Yet, their impact is unclear.
OBJECTIVES
Systematically review AMS apps and their impact on prescribing by physicians treating in-hospital patients.
DATA SOURCES
EMBASE, MEDLINE (Ovid), Cochrane Central, Web of Science and Google Scholar.
STUDY ELIGIBILITY CRITERIA
Studies focusing on smartphone or tablet apps and antimicrobial therapy published from January 2008 until February 28th 2019 were included.
PARTICIPANTS
Physicians treating in-hospital patients.
INTERVENTIONS
AMS apps.
METHODS
Systematic review.
RESULTS
Thirteen studies met the eligibility criteria. None was a randomized controlled trial. Methodological study quality was considered low to moderate in all but three qualitative studies. The primary outcomes were process indicators, adherence to guidelines and user experience. Guidelines were more frequently accessed by app (53.0% - 89.6%) than by desktop in three studies. Adherence to guidelines increased (6.5% - 74.0%) significantly for several indications after app implementation in four studies. Most users considered app use easy (77.4%->90.0%) and useful (71.0%->90%) in three studies and preferred it over guideline access by web viewer or booklet in two studies. However, some physicians regarded app use adjacent to colleagues or patients unprofessional in three qualitative studies. Susceptibility to several antimicrobials changed significantly post-intervention (from 5% decrease to 10% - 14% increase) in one study.
CONCLUSIONS
Use of AMS apps seems to promote access to and knowledge of antimicrobial prescribing policy, and increase adherence to guidelines in hospitals. However, this has been assessed in a limited number of studies and for specific indications. Good quality studies are necessary to properly assess the impact of AMS apps on antimicrobial prescribing. To improve adherence to antimicrobial guidelines, use of AMS apps could be considered.
Identifiants
pubmed: 32991591
doi: 10.1371/journal.pone.0239751
pii: PONE-D-20-18292
pmc: PMC7523951
doi:
Substances chimiques
Anti-Infective Agents
0
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0239751Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
J Antimicrob Chemother. 2018 Aug 1;73(8):2236-2242
pubmed: 29746647
Clin Microbiol Infect. 2017 Aug;23(8):524-532
pubmed: 28268133
J Antimicrob Chemother. 2019 Feb 1;74(2):515-520
pubmed: 30445465
Int J Pharm Pract. 2017 Feb;25(1):5-17
pubmed: 27198585
Braz J Infect Dis. 2017 Nov - Dec;21(6):660-664
pubmed: 28941393
Eur J Clin Microbiol Infect Dis. 2015 Aug;34(8):1631-7
pubmed: 26017664
Lancet Infect Dis. 2016 Jul;16(7):847-856
pubmed: 26947617
Int J Med Inform. 2016 Aug;92:15-34
pubmed: 27318068
Clin Infect Dis. 2013 Sep;57(5):631-8
pubmed: 23728148
Am J Infect Control. 2017 Mar 1;45(3):317-320
pubmed: 27838166
PLoS One. 2016 Apr 25;11(4):e0154202
pubmed: 27111775
Drug Saf. 2015 Sep;38(9):833-43
pubmed: 26115701
J Pathol Inform. 2018 Apr 02;9:10
pubmed: 29692947
PLoS Negl Trop Dis. 2017 Jan 19;11(1):e0005290
pubmed: 28103233
BMC Med Educ. 2018 Jul 31;18(1):175
pubmed: 30064424
J Antimicrob Chemother. 2017 Jun 1;72(6):1825-1831
pubmed: 28333297
J Antimicrob Chemother. 1992 Nov;30(5):724-7
pubmed: 1493990
Rev Bras Ginecol Obstet. 2019 Feb;41(2):97-101
pubmed: 30786306
PLoS One. 2019 Jan 29;14(1):e0211157
pubmed: 30695078
Infect Dis Rep. 2017 Mar 30;9(1):6821
pubmed: 28458795
S Afr Med J. 2017 Apr 25;107(5):405-410
pubmed: 28492121
Curr Infect Dis Rep. 2019 Jul 24;21(8):29
pubmed: 31342180
JMIR Mhealth Uhealth. 2018 Jun 11;6(6):e10263
pubmed: 29891469
Clin Infect Dis. 2010 May 1;50(9):1268-74
pubmed: 20233061
Med Clin North Am. 2018 Sep;102(5):955-963
pubmed: 30126584
J Antimicrob Chemother. 2018 Aug 1;73(8):2201-2206
pubmed: 29718336
Int J Med Educ. 2017 Nov 30;8:416-420
pubmed: 29200402
Infect Control Hosp Epidemiol. 2016 May;37(5):603-5
pubmed: 26809753
J Antimicrob Chemother. 2018 Jun 1;73(suppl_6):vi40-vi49
pubmed: 29878218
BMJ. 2009 Jul 21;339:b2535
pubmed: 19622551
PLoS One. 2014 Jan 03;9(1):e79802
pubmed: 24404122
Infect Control Hosp Epidemiol. 2018 Aug;39(8):986-988
pubmed: 29925458
BMJ Open. 2020 Jun 4;10(6):e033640
pubmed: 32503867
J Antimicrob Chemother. 2020 May 1;75(5):1099-1111
pubmed: 31960021
JMIR Mhealth Uhealth. 2016 Jul 06;4(3):e83
pubmed: 27383743
J Antimicrob Chemother. 2013 Apr;68(4):960-7
pubmed: 23258314
Cochrane Database Syst Rev. 2017 Feb 09;2:CD003543
pubmed: 28178770
Health Informatics J. 2014 Mar;20(1):59-73
pubmed: 24550565
Infect Control Hosp Epidemiol. 2014 Oct;35(10):1209-28
pubmed: 25203174
J Antimicrob Chemother. 2018 Jul 1;73(7):1984-1988
pubmed: 29590400