Gamified antimicrobial decision support app (GADSA) changes antibiotics prescription behaviour in surgeons in Nigeria: a hospital-based pilot study.
Gamified antimicrobial decision support app (GADSA) changes antibiotics prescription behaviour in surgeons in Nigeria: a hospital-based pilot study.
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DOI：
10.1186/s13756-023-01342-9
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发表时间：
2023-12-06
影响因子：
5.5
通讯作者：
Kostkova, Patty
中科院分区：
文献类型：
--
作者：
Luedtke, Susanne;Wood, Caroline;Olufemi, Olajumoke;Okonji, Patrick;Kpokiri, Eneyi E.;Musah, Anwar;Bammeke, Funmi;Mutiu, Bamidele;Ojewola, Rufus;Bankole, Olufemi;Ademuyiwa, Adesoji;Ekumankama, Chibuzo;Theophilus, Ayibanoah;Aworabhi-Oki, Neni;Shallcross, Laura;Molnar, Andreea;Wiseman, Sue;Hayward, Andrew;Birjovanu, Georgiana;Lefevre, Carmen;Petrou, Stylianos;Ogunsola, Folasade;Kostkova, Patty
尼日利亚的外科抗生素预防（SAP）通常没有证据基础。这项研究的目的是测试GADSA应用程序是否可以改变尼日利亚外科医生的处方行为。此外，本研究旨在确定AMS未来的策略和政策。GADSA的游戏化决策支持应用程序使用世卫组织和桑福德的处方指南，通过互动导师向外科医生提供实时的说服性技术反馈。该应用程序可以就临床医生的决定是否符合SAP的建议提供建议，并为临床医生提供调整的机会。20名外科医生积极参加了在尼日利亚三家医院进行的为期6个月的试点研究。外科医生确定手术过程感染的风险，以及SAP的需求、类型和持续时间。该研究采用纵向方法，通过分析应用程序中报告的处方决策，测试GADSA应用程序是否显著改变了参与外科医生的处方行为。记录了321张SAP处方。关于手术风险决策，12%的外科医生在应用程序反馈后改变了他们的决定以符合指南（p < 0.001）， 10%的外科医生改变了他们关于SAP需要的决定（p = 0.0035）以符合指南。SAP使用的决策在“类型”和“持续时间”方面的变化与指导方针相一致，分别为6%和5% （p值均< 0.001）。这项研究表明，GADSA应用程序具有基于游戏和反馈功能，可以显着改变非洲环境中医疗点的处方行为，这可以帮助解决抗生素耐药性的全球挑战。
Surgical Antibiotic Prophylaxis (SAP) in Nigeria is often not evidence based. The aim of this study is to test if the GADSA application can change prescription behaviour of surgeons in Nigeria. In addition, the study aims to identify AMS strategies and policies for the future. The GADSA gamified decision support app uses WHO and Sanford prescribing guidelines to deliver real-time persuasive technology feedback to surgeons through an interactive mentor. The app can advise on whether clinician’s decisions align with SAP recommendations and provides the opportunity for clinicians to make adjustments. Twenty surgeons actively participated in a 6-month pilot study in three hospitals in Nigeria. The surgeons determined the risk of infection of a surgical procedure, and the need, type and duration of SAP. The study used a longitudinal approach to test whether the GADSA app significantly changed prescribing behaviour of participating surgeons by analysing the reported prescription decisions within the app. 321 SAP prescriptions were recorded. Concerning the surgical risk decision, 12% of surgeons changed their decision to be in line with guidelines after app feedback (p < 0.001) and 10% of surgeons changed their decision about the need for SAP (p = 0.0035) to align with guidelines. The change in decision making for SAP use in terms of “type” and “duration” to align with guidelines was similar with 6% and 5% respectively (both p-values < 0.001). This study suggests that the GADSA app, with its game based and feedback feature, could significantly change prescribing behaviour at the point of care in an African setting, which could help tackle the global challenge of antibiotic resistance.
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影响因子：
11.1
作者：
Albarqouni, Loai;Palagama, Sujeewa;Chai, Julia;Sivananthajothy, Priatharsini;Pathirana, Thanya;Bakhit, Mina;Arab-Zozani, Morteza;Ranakusuma, Respati;Cardona, Magnolia;Scott, Anna;Clark, Justin;Smith, Claire Friedemann;Effa, Emmanuel;Ochodo, Eleanor;Moynihan, Ray
通讯作者：
Moynihan, Ray
影响因子：
5.5
作者：
Elton, Linzy;Thomason, Margaret J.;McHugh, Timothy D.
通讯作者：
McHugh, Timothy D.
影响因子：
5.2
作者：
Pulcini, Celine;Gyssens, Inge C.
通讯作者：
Gyssens, Inge C.
影响因子：
56.3
作者：
Brink, Adrian J.;Messina, Angeliki P.;van den Bergh, Dena
通讯作者：
van den Bergh, Dena
影响因子：
11.8
作者：
Glowacki, RC;Schwartz, DN;Weinstein, RA
通讯作者：
Weinstein, RA