title: Clinical decision support to improve antibiotic prescribing for acute respiratory infections: results of a pilot study.
abstract: Acute Respiratory Infections (ARIs) are the number one reason for antibiotic prescribing in the United States, and much antibiotic prescribing for ARIs is inappropriate. We designed an electronic health record-integrated, documentation-based clinical decision support system for the care of patients with ARIs, the ARI Smart Form. To evaluate the ARI Smart Form and assess the feasibility of performing a larger trial, we conducted a pilot study with 10 clinicians who used the ARI Smart Form with 26 patients. Clinicians prescribed antibiotics to 6 of 6 patients with antibiotic-appropriate diagnoses and to 3 of 20 (15%) patients with antibiotic-inappropriate diagnoses. The average duration of use of the ARI Smart Form was 7.5 (SD+/-4.5) minutes. Eight of 10 respondents reported that the ARI Smart Form was either time-neutral or timesaving. The ARI Smart Form requires further evaluation but has the potential to improve workflow and reduce inappropriate antibiotic prescribing.
authors.affiliation: Brigham and Women's Hospital and Harvard Medical School.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Linder
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Schnipper
authors.forename: Lynn A
authors.initials: LA
authors.lastname: Volk
authors.forename: Ruslana
authors.initials: R
authors.lastname: Tsurikova
authors.forename: Matvey
authors.initials: M
authors.lastname: Palchuk
authors.forename: Maya
authors.initials: M
authors.lastname: Olsha-Yehiav
authors.forename: Andrea J
authors.initials: AJ
authors.lastname: Melnikas
authors.forename: Blackford
authors.initials: B
authors.lastname: Middleton
mesh_terms: D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D003625:Data Collection; D020000:Decision Support Systems, Clinical; D004360:Drug Therapy, Computer-Assisted; D017723:Drug Utilization Review; D005260:Female; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized; D010865:Pilot Projects; D010818:Practice Patterns, Physicians'; D012141:Respiratory Tract Infections / Q000188:drug therapy*; D018511:Systems Integration; D014584:User-Computer Interface
chemical_list: D000900:Anti-Bacterial Agents