Title | ||
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Research Paper: Use of a Personal Digital Assistant for Managing Antibiotic Prescribing for Outpatient Respiratory Tract Infections in Rural Communities |
Abstract | ||
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Objective: To assess the acceptability and usage of a standalone personal digital assistant (PDA)-based clinical decision-support system (CDSS) for the diagnosis and management of acute respiratory tract infections (RTIs) in the outpatient setting. Design: Observational study performed as part of a larger randomized trial in six rural communities in Utah and Idaho from January 2002 to March 2004. Ninety-nine primary care providers received a PDA-based CDSS for use at the point-of-care, and were asked to use the tool with at least 200 patients with suspected RTIs. Measurements: Clinical data were collected electronically from the devices at periodic intervals. Providers also completed an exit questionnaire at the end of the study period. Results: Providers logged 14,393 cases using the CDSS, the majority of which (n = 7624; 53%) were from family practitioners. Overall adherence with CDSS recommendations for the five most common diagnoses (pharyngitis, otitis media, sinusitis, bronchitis, and upper respiratory tract infection) was 82%. When antibiotics were prescribed (53% of cases), adherence with the CDSS-recommended antibiotic was high (76%). By logistic regression analysis, the odds of adherence with CDSS recommendations increased significantly with each ten cases completed (P = 0.001). Questionnaire respondents believed the CDSS was easy to use, and most (44/65; 68%) did not believe it increased their encounter time with patients, regardless of prior experience with PDAs. Conclusion: A standalone PDA-based CDSS for acute RTIs used at the point-of-care can encourage better outpatient antimicrobial prescribing practices and easily gather a rich set of clinical data. |
Year | DOI | Venue |
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2006 | 10.1197/jamia.M2029 | Journal of the American Medical Informatics Association |
DocType | Volume | Issue |
Journal | 13 | 6 |
ISSN | Citations | PageRank |
1067-5027 | 1 | 0.40 |
References | Authors | |
0 | 7 |
Name | Order | Citations | PageRank |
---|---|---|---|
Michael Rubin | 1 | 12 | 2.27 |
Kim Bateman | 2 | 3 | 0.78 |
Sharon Donnelly | 3 | 1 | 0.73 |
Gregory J. Stoddard | 4 | 5 | 2.27 |
Kurt Stevenson | 5 | 2 | 1.15 |
Reed M. Gardner | 6 | 59 | 20.31 |
Matthew H. Samore | 7 | 143 | 26.07 |