Study protocol for an international, multicentre stepped-wedge cluster randomised trial to evaluate the impact of a digital antimicrobial stewardship smartphone application

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Helou, R. , I (author)

Study protocol for an international, multicentre stepped-wedge cluster randomised trial to evaluate the impact of a digital antimicrobial stewardship smartphone application

Article/chapterEnglish2020

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2020-06-04
BMJ PUBLISHING GROUP,2020
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LIBRIS-ID:oai:DiVA.org:uu-421747
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-421747URI
https://doi.org/10.1136/bmjopen-2019-033640DOI

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Language:English
Summary in:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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IntroductionWith the widespread use of electronic health records and handheld electronic devices in hospitals, informatics-based antimicrobial stewardship interventions hold great promise as tools to promote appropriate antimicrobial drug prescribing. However, more research is needed to evaluate their optimal design and impact on quantity and quality of antimicrobial prescribing.Methods and analysisUse of smartphone-based digital stewardship applications (apps) with local guideline directed empirical antimicrobial use by physicians will be compared with antimicrobial prescription as per usual as primary outcome in three hospitals in the Netherlands, Sweden and Switzerland. Secondary outcomes will include antimicrobial use metrics, clinical and process outcomes. A multicentre stepped-wedge cluster randomised trial will randomise entities defined as wards or specialty regarding time of introduction of the intervention. We will include 36 hospital entities with seven measurement periods in which the primary outcome will be measured in 15 participating patients per time period per cluster. At participating wards, patients of at least 18 years of age using antimicrobials will be included. After a baseline period of 2-week measurements, six periods of 4 weeks will follow in which the intervention is introduced in 6 wards (in three hospitals) until all 36 wards have implemented the intervention. Thereafter, we allow use of the app by everyone, and evaluate the sustainability of the app use 6 months later.Ethics and disseminationThis protocol has been approved by the institutional review board of each participating centre. Results will be disseminated via media, to healthcare professionals via professional training and meetings and to researchers via conferences and publications.Trial registration numberClinicalTrials.gov registry (NCT03793946). Stage; pre-results.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Allmänmedicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine General Practice hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences Health Care Service and Management, Health Policy and Services and Health Economy hsv//eng
infectious diseases
microbiology
protocols & guidelines
information technology
therapeutics

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Catho, GaudHop Univ Geneve, Dept Infect Dis, Geneva, Switzerland. (author)
Latif, Annabel PeyraviUppsala universitet,Infektionsmedicin(Swepub:uu)annek376 (author)
Mouton, JohanErasmus MC, Dept Med Microbiol & Infect Dis, Rotterdam, Netherlands. (author)
Hulscher, M.Radboud Univ Nijmegen, Sci Ctr Qual Healthcare IQ Healthcare, Radboud Inst Hlth Sci, Med Ctr, Nijmegen, Netherlands. (author)
Teerenstra, StevenRadboud Univ Nijmegen, Radboud Inst Hlth Sci, Dept Hlth Evidence, Med Ctr, Nijmegen, Netherlands. (author)
Conly, JohnUniv Calgary, Dept Med, Calgary, AB, Canada.;Alberta Hlth Serv, Calgary, AB, Canada. (author)
Huttner, Benedikt D.Hop Univ Geneve, Dept Infect Dis, Geneva, Switzerland. (author)
Tängdén, ThomasUppsala universitet,Infektionsmedicin(Swepub:uu)thota437 (author)
Verbon, AnneliesErasmus MC, Dept Med Microbiol & Infect Dis, Rotterdam, Netherlands. (author)
Hop Univ Geneve, Dept Infect Dis, Geneva, Switzerland.Infektionsmedicin (creator_code:org_t)

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By the author/editor: Helou, R. , I; Catho, Gaud; Latif, Annabel P ...; Mouton, Johan; Hulscher, M.; Teerenstra, Stev ...; show more...; Conly, John; Huttner, Benedik ...; Tängdén, Thomas; Verbon, Annelies; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and General Practice

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