A mobile health tool to improve antibiotic stewardship among village doctors in Bangladesh

移动医疗工具可改善孟加拉国乡村医生的抗生素管理

• 批准号: 10527016
• 负责人: Ashraful Islam Khan
• 金额: $ 19.8万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-19 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10527016
• 关键词: 5 year old; Accounting; Acute Diarrhea; Age; Antibiotics; Antimicrobial Resistance; Bangladesh; Blood; Breast Feeding; Car Phone; Caregivers; Cause of Death; Cessation of life; Child; Childhood; Climate; Clinical; Clinical Management; Collaborations; Cross-Over Trials; Custom; Data; Development; Diagnosis; Diagnostic; Diarrhea; Drug Prescriptions; Etiology; Feasibility Studies; Feces; Fever; Fostering; Goals; Habits; Health; Health Personnel; Healthcare; Individual; Knowledge; Laboratories; Lead; Location; Measures; Medical; Methods; Mobile Health Application; Modeling; Modification; Morbidity - disease rate; Patient Care; Patients; Performance; Phase; Physicians; Population; Prevalence; Primary Health Care; Provider; Randomized; Randomized Controlled Trials; Rehydrations; Rural; Site; Syndrome; Testing; Toxic effect; Training; Trust; Viral; Vomiting; Work; acceptability and feasibility; antimicrobial; base; care costs; clinical application; clinical decision support; clinical decision-making; cost; diarrheal disease; evidence base; feasibility trial; implementation strategy; improved; innovation; low and middle-income countries; mHealth; mortality; pathogen; predictive modeling; predictive tools; research and development; respiratory; rural area; rural healthcare; rural setting; support tools; tool

Abstract Diarrheal diseases are the among the leading cause of death in children worldwide, most of which occur in low- and middle-income countries (LMICs). The cornerstone for management of diarrhea is rehydration, though antimicrobials are beneficial in some instances. Unfortunately, given that treatment is frequently empiric, based mostly on clinical suspicion for bacterial causes, antimicrobials are overused in management of diarrheal illness worldwide. Thus, there is a need for clinical decision support tools to inform clinical management and promote antimicrobial stewardship. In particular, frontline healthcare providers in rural areas, such as village doctors in Bangladesh, often have inadequate knowledge for the basis of antimicrobial use, and may benefit greatly from guidance. We have recently developed a mobile phone based electronic clinical decision-support tool (eCDST), and shown the impact of etiological prediction on physician antibiotic prescription practices for pediatric diarrhea in two LMICs. In this proposal, our overarching goal is to customize our eCDST into a comprehensive mHealth application (Accessible Diarrhea Etiology Prediction Tool, ADEPT) to support rural health care providers in the management of pediatric diarrhea (R21 phase), and to measure its impact through the performance of a pilot before-after feasibility study (R33 phase). Our work will contribute to an evidence base for mHealth-enabled antimicrobial stewardship, with potential to extend beyond diarrheal illness, and into other syndromes, including respiratory illness and febrile illness.

摘要