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Short-Duration Electronic Health Record Option Buttons to Reduce Prolonged Length of Antibiotic Therapy in Outpatients.

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Title: Short-Duration Electronic Health Record Option Buttons to Reduce Prolonged Length of Antibiotic Therapy in Outpatients.
Authors: Sun, Shan, Jones, Roderick C., Fricchione, Marielle J., Scardina, Tonya L., Healy, Daniel, Patel, Rupal M., Patel, Sameer J.
Source: Pediatrics. Jun2021, Vol. 147 Issue 6, p1-7. 7p.
Subjects: Outpatients, Antibiotics, Confidence intervals, Time, Treatment duration, Patient readmissions, Time series analysis, Drug prescribing, Drugs, Descriptive statistics, Electronic health records, Physician practice patterns
Abstract: BACKGROUND: Prolonged antibiotic therapy may be associated with increased adverse events and antibiotic resistance. We deployed an intervention in the electronic health record (EHR) to reduce antibiotic duration for pediatric outpatients. METHODS: A preintervention and postintervention interrupted time series analysis of antibiotic duration for 7 antibiotics was performed for patients discharged from the ED and clinics of a children's hospital network from 2012 to 2018. In February 2015, clickable 5- and 7-day duration option buttons were deployed in the EHR for clindamycin, cephalexin, ciprofloxacin and levofloxacin, trimethoprim-sulfamethoxazole, amoxicillin, and cefdinir, with an additional 10-day option for the latter 2. Prescribers were able to enter a free-text duration. The option buttons were not announced, and were not linked to a specific diagnosis or quality improvement initiative. The primary outcome was proportion of prescriptions per month with duration of 10 days. Balancing secondary outcomes were reorders of the same agent, return to clinic, and inpatient admissions within 30 days. RESULTS: There were 54 315 prescriptions for the 7 antibiotics associated with 39 894 patients, 18 683 clinic visits, and 35 632 ED visits. Overall, a 25.1% (95% confidence interval [CI], 28.3% to 22.0%) change in the proportion of prescriptions with a 10-day duration was attributable to the intervention, with larger effects noted for clindamycin (220.8% [95% CI, 226.9% to 214.7%]) and cephalexin (29.9% [95% CI, 214.3% to 25.4%]). There was no increase in the reorders of the same agent, return clinical encounters, or inpatient admissions within 30 days. CONCLUSIONS: A simple intervention in the EHR can safely reduce duration of antibiotic therapy. [ABSTRACT FROM AUTHOR]
Copyright of Pediatrics is the property of American Academy of Pediatrics and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Short-Duration Electronic Health Record Option Buttons to Reduce Prolonged Length of Antibiotic Therapy in Outpatients.
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  Data: <searchLink fieldCode="AR" term="%22Sun%2C+Shan%22">Sun, Shan</searchLink><br /><searchLink fieldCode="AR" term="%22Jones%2C+Roderick+C%2E%22">Jones, Roderick C.</searchLink><br /><searchLink fieldCode="AR" term="%22Fricchione%2C+Marielle+J%2E%22">Fricchione, Marielle J.</searchLink><br /><searchLink fieldCode="AR" term="%22Scardina%2C+Tonya+L%2E%22">Scardina, Tonya L.</searchLink><br /><searchLink fieldCode="AR" term="%22Healy%2C+Daniel%22">Healy, Daniel</searchLink><br /><searchLink fieldCode="AR" term="%22Patel%2C+Rupal+M%2E%22">Patel, Rupal M.</searchLink><br /><searchLink fieldCode="AR" term="%22Patel%2C+Sameer+J%2E%22">Patel, Sameer J.</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Pediatrics%22">Pediatrics</searchLink>. Jun2021, Vol. 147 Issue 6, p1-7. 7p.
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  Data: <searchLink fieldCode="DE" term="%22Outpatients%22">Outpatients</searchLink><br /><searchLink fieldCode="DE" term="%22Antibiotics%22">Antibiotics</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Time%22">Time</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+duration%22">Treatment duration</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+readmissions%22">Patient readmissions</searchLink><br /><searchLink fieldCode="DE" term="%22Time+series+analysis%22">Time series analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+prescribing%22">Drug prescribing</searchLink><br /><searchLink fieldCode="DE" term="%22Drugs%22">Drugs</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Electronic+health+records%22">Electronic health records</searchLink><br /><searchLink fieldCode="DE" term="%22Physician+practice+patterns%22">Physician practice patterns</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: BACKGROUND: Prolonged antibiotic therapy may be associated with increased adverse events and antibiotic resistance. We deployed an intervention in the electronic health record (EHR) to reduce antibiotic duration for pediatric outpatients. METHODS: A preintervention and postintervention interrupted time series analysis of antibiotic duration for 7 antibiotics was performed for patients discharged from the ED and clinics of a children's hospital network from 2012 to 2018. In February 2015, clickable 5- and 7-day duration option buttons were deployed in the EHR for clindamycin, cephalexin, ciprofloxacin and levofloxacin, trimethoprim-sulfamethoxazole, amoxicillin, and cefdinir, with an additional 10-day option for the latter 2. Prescribers were able to enter a free-text duration. The option buttons were not announced, and were not linked to a specific diagnosis or quality improvement initiative. The primary outcome was proportion of prescriptions per month with duration of 10 days. Balancing secondary outcomes were reorders of the same agent, return to clinic, and inpatient admissions within 30 days. RESULTS: There were 54 315 prescriptions for the 7 antibiotics associated with 39 894 patients, 18 683 clinic visits, and 35 632 ED visits. Overall, a 25.1% (95% confidence interval [CI], 28.3% to 22.0%) change in the proportion of prescriptions with a 10-day duration was attributable to the intervention, with larger effects noted for clindamycin (220.8% [95% CI, 226.9% to 214.7%]) and cephalexin (29.9% [95% CI, 214.3% to 25.4%]). There was no increase in the reorders of the same agent, return clinical encounters, or inpatient admissions within 30 days. CONCLUSIONS: A simple intervention in the EHR can safely reduce duration of antibiotic therapy. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Pediatrics is the property of American Academy of Pediatrics and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=150721845
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      – Type: doi
        Value: 10.1542/peds.2020-034819
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      – Code: eng
        Text: English
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      Pagination:
        PageCount: 7
        StartPage: 1
    Subjects:
      – SubjectFull: Outpatients
        Type: general
      – SubjectFull: Antibiotics
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Time
        Type: general
      – SubjectFull: Treatment duration
        Type: general
      – SubjectFull: Patient readmissions
        Type: general
      – SubjectFull: Time series analysis
        Type: general
      – SubjectFull: Drug prescribing
        Type: general
      – SubjectFull: Drugs
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      – SubjectFull: Descriptive statistics
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      – SubjectFull: Electronic health records
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      – SubjectFull: Physician practice patterns
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      – TitleFull: Short-Duration Electronic Health Record Option Buttons to Reduce Prolonged Length of Antibiotic Therapy in Outpatients.
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              Text: Jun2021
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              Y: 2021
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