Capital and Coast DHB in New Zealand develops antibiotic prescribing app
An antibiotic prescribing app developed at Capital and Coast District Health Board (DHB) has improved doctors’ adherence to prescribing guidelines.
Developed by the DHB’s Infection Services with computer science students from the Victoria University of Wellington, the Empiric app gives prescribers easy mobile access to antibiotic guidelines and assists with clinical decision making.
Empiric prescribing is when a doctor chooses an antibiotic before knowing exactly what micro-organisms are involved, so they prescribe according to the symptoms. Between 35–50 per cent of hospital inpatients are on antibiotics at any one time.
Most large DHBs will have their own empiric antibiotic prescribing guidelines, which are often used by the smaller local DHBs.
Previously these guidelines were either in a booklet or on a website, which meant doctors had to either carry a paper copy or find a computer terminal to look them up.
Infection Services clinical leader Dr Michelle Balm says that while adherence to the guidelines was good, there was room for improvement.
“We wanted to make it a lot easier for prescribers to make good clinical decisions about antibiotics use as close to bedside as possible,” Balm said.
Empiric is automatically downloaded on to all the DHB smartphones that are given to junior doctors in place of the traditional pager.
Figures show all junior doctors are using it weekly and most on a daily basis, and adherence to the guidelines has increased since the app was introduced. Doctors report that it increases confidence around prescribing.
The app is also free to download on the Apple and Android app stores and has been downloaded 700 times outside the DHB.
Balm says that while there are regional differences, the prescribing guidelines are broadly applicable across New Zealand, and that the DHB made Empiric freely available for anyone to use, “in the interest of transparency and to try and get a national discussion going on this topic”.
Empiric takes prescribers through a set of questions to produce a personalised – rather than generic – prescription recommendation. Features include options for when a patient has an allergy and where there is a risk of multi-drug resistant organism.