Antibiotic Prescription Relevance Indicators: Calculation From Electronic Health Records (ARIPPA)

  • STATUS
    Recruiting
  • End date
    Dec 31, 2024
  • participants needed
    2115
  • sponsor
    University Hospital, Bordeaux
Updated on 5 July 2022

Summary

This research focuses on the development and validation of indicators on the relevance of antibiotic prescriptions. The investigators want to propose transferable tools to other healthcare institutions to allow automated construction of quality indicators as part of a structured approach to improve future practices. The main objective of the study is to develop indicators on the appropriateness of antibiotic prescriptions and on surgical prophylaxis automated from the hospital information system and to assess their criterion validity.

Description

According to the national program to control Antimicrobial resistance, hospitals are required to report two indicators on antibiotic prescriptions appropriateness: 1/the percentage of inappropriate treatment among treatments lasting more than 7 days; 2/the percentage of surgical antibiotic prophylaxis lasting more than 24 hours.

These indicators are collected via practice audits that are time-consuming and cover a limited number of patient records.

The main objective of ARIPPA project is to assess the ability of an automatic tool to detect inappropriate antibiotic prescriptions directly from the electronic health records (sensitivity). Secondary objectives are 1) to assess the specificity, positive predictive value and negative predictive value of the tool for automatically calculating indicators of the relevance of antibiotic prescriptions from information systems, 2) to assess the impact of individual and collective feedbacks on antibiotic prescription appropriateness 3) to explore acceptability of this automated tool by prescribers.

This observational study consists in 4 steps: 1/ development of the automatic tool to detect inappropriate antibiotic prescriptions directly from the electronic health records - for treatments lasting more than 7 days, the study will focus on respiratory infections and urinary tract infections which are the most common infections in hospitals; 2/ assessment of metrologic performance of the tool by comparison to practice audits as the gold standard; 3/ feedback of the indicators to the prescribers and 4/ evaluation of the impact of this feedback on appropriateness of antibiotic prescriptions.

This project will be piloted at Bordeaux University hospital and then implemented in other public hospitals belonging to a same territorial organization. As each hospital information system is different, the investigators will propose transposable tools to other healthcare institutions to allow an automated construction of these indicators.

Details
Condition Surgery, Antibiotic
Treatment Automatic tool to identify inappropriate antibiotic prescriptions
Clinical Study IdentifierNCT05420168
SponsorUniversity Hospital, Bordeaux
Last Modified on5 July 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Patients whose medical and administrative data are available in an electronic format in the hospital information system
Adult patients aged over 18
Patients hospitalized at the Bordeaux University Hospital or one of the hospital of the territorial organization
Patients hospitalized between 01/01/2022 and 31/12/2024
Indicator 1: "antibiotic treatments of more than 7 days without justifications
Patients with of a hospitalization of more than 24 hours
Patients with urinary or respiratory infections on admission or during the hospitalization (including sepsis related to urinary or respiratory infection)
Patients with a prescription for at least one antibiotic, initiated on admission or during the hospitalization, for more than 7 days including the hospital prescription AND the discharge prescription
Indicator 2: "surgical antibiotic prophylaxis lasting more than 24 hours
Patients with surgery requiring an antibiotic prophylaxis
Patients having received antibiotic prophylaxis

Exclusion Criteria

Patients not hospitalized at the Bordeaux University Hospital or one of the hospital of the territorial organization
Patients whose medical and administrative data are not available in an electronic format in the hospital information system
Patients who have refused the secondary use of their data for research purpose
Indicator 1: "Indicator of antibiotic treatments of more than 7 days without justifications
Patients with another concomitant infectious pathology
Patient with pulmonary or urinary tuberculosis
Indicator 2: "surgical antibiotic prophylaxis lasting more than 24 hours
Patients without any surgery or with surgery for which antibiotic prophylaxis is not required
Patients without antibiotic prophylaxis
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