- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05420168
Antibiotic Prescription Relevance Indicators: Calculation From Electronic Health Records (ARIPPA)
Automatisation du Recueil d'Indicateurs de Pertinence de Prescription d'Antibiotiques : Développement, Validation et efficacité d'un Outil Utilisant Les systèmes d'Information d'un Groupement Hospitalier de Territoire
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
According to the national program to control Antimicrobial resistance, hospitals are required to report two indicators on antibiotic prescriptions appropriateness: 1/the percentage of inappropriate treatment among treatments lasting more than 7 days; 2/the percentage of surgical antibiotic prophylaxis lasting more than 24 hours.
These indicators are collected via practice audits that are time-consuming and cover a limited number of patient records.
The main objective of ARIPPA project is to assess the ability of an automatic tool to detect inappropriate antibiotic prescriptions directly from the electronic health records (sensitivity). Secondary objectives are 1) to assess the specificity, positive predictive value and negative predictive value of the tool for automatically calculating indicators of the relevance of antibiotic prescriptions from information systems, 2) to assess the impact of individual and collective feedbacks on antibiotic prescription appropriateness 3) to explore acceptability of this automated tool by prescribers.
This observational study consists in 4 steps: 1/ development of the automatic tool to detect inappropriate antibiotic prescriptions directly from the electronic health records - for treatments lasting more than 7 days, the study will focus on respiratory infections and urinary tract infections which are the most common infections in hospitals; 2/ assessment of metrologic performance of the tool by comparison to practice audits as the gold standard; 3/ feedback of the indicators to the prescribers and 4/ evaluation of the impact of this feedback on appropriateness of antibiotic prescriptions.
This project will be piloted at Bordeaux University hospital and then implemented in other public hospitals belonging to a same territorial organization. As each hospital information system is different, the investigators will propose transposable tools to other healthcare institutions to allow an automated construction of these indicators.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Contact
- Name: Frantz THIESSARD, MD, PhD
- Phone Number: + 33 557 574 522
- Email: frantz.thiessard@u-bordeaux.fr ; frantz.thiessard@chu-bordeaux.fr
Study Contact Backup
- Name: Catherine DUMARTIN, PharmD; PhD
- Phone Number: + 33 556 796 058
- Email: catherine.dumartin@chu-bordeaux.fr
Study Locations
-
-
-
Arcachon, France, 33120
- Not yet recruiting
- Arcachon Hospital
-
Contact:
- Stéphanie Bez, MD
- Email: stephanie.bez@ch-arcachon.fr
-
Principal Investigator:
- Stéphanie Bez, MD
-
Sub-Investigator:
- Pierre Labadens, MD
-
Sub-Investigator:
- Martha Videcoq, MD
-
Sub-Investigator:
- Fabien Giroux, MD
-
Sub-Investigator:
- Catherine De Montaudouin, MD
-
Sub-Investigator:
- Mélanie Gautier, PharmD
-
Blaye, France, 33390
- Not yet recruiting
- Blaye Hospital
-
Contact:
- Cathy Rakotomalala, MD
- Email: rakotomalala@chblaye.fr
-
Principal Investigator:
- Cathy Rakotomalala, MD
-
Sub-Investigator:
- Elodie Arnaud, PharmD
-
Bordeaux, France, 33000
- Recruiting
- Bordeaux university hospital
-
Sub-Investigator:
- Romain Griffier, MD
-
Contact:
- Anne-Marie Rogues, MD PhD
- Email: anne-marie.rogues@chu-bordeaux.fr
-
Principal Investigator:
- Anne-Marie Rogues, MD PhD
-
Sub-Investigator:
- Vianney Jouhet, MD PhD
-
Sub-Investigator:
- Charles Cazanave, MD PhD
-
Sub-Investigator:
- Arnaud Desclaux, MD PhD
-
Sub-Investigator:
- Stephane Pedeboscq, PharmD PhD
-
Sub-Investigator:
- Véronique Gilleron, MD
-
Sub-Investigator:
- Eric Ouattara, MD
-
Sub-Investigator:
- Maider Coppry, PharmD PhD
-
Bordeaux, France, 33000
- Not yet recruiting
- Charles Perrens Hospital
-
Contact:
- Françoise Obeniche, MD
- Email: fobeniche@ch-perrens.fr
-
Principal Investigator:
- Françoise Obeniche, MD
-
Sub-Investigator:
- Anne Colombe, PharmD
-
Sub-Investigator:
- Anne-Laure Debruyne, PharmD
-
Sub-Investigator:
- Elisabeth Goumard, MD
-
Cadillac, France, 33410
- Not yet recruiting
- Cadillac Hospital
-
Contact:
- Laurence Parneix-Sediey, PharmD
- Email: laurence.parneix@ch-cadillac.fr
-
Principal Investigator:
- Laurence Parneix-Sediey, PharmD
-
Sub-Investigator:
- Bérénice Bréchat-Huet, MD
-
Langon, France, 33210
- Not yet recruiting
- Sud-Gironde Hospital
-
Contact:
- Philippe Cormier, MD
- Email: Philippe.cormier@ch-sudgironde.fr
-
Principal Investigator:
- Philippe Cormier, MD
-
Sub-Investigator:
- Bernard Caumont, MD
-
Sub-Investigator:
- Dominique Gauthier, MD
-
Sub-Investigator:
- Thierry Dufoir, PharmD
-
Libourne, France
- Not yet recruiting
- Libourne Hospital
-
Contact:
- Caroline Fondrinier, PharmD
- Email: Caroline.fondrinier@ch-libourne.fr
-
Principal Investigator:
- Caroline Fondrinier, PharmD
-
Sainte Foy la Grande, France, 33220
- Not yet recruiting
- Sainte Foy la Grande Hospital
-
Contact:
- Corinne Thé, PharmD
- Email: Corinne.The@ch-sudgironde.fr
-
Principal Investigator:
- Corinne Thé, PharmD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Patients whose medical and administrative data are available in an electronic format in the hospital information system
- Adult patients aged over 18;
- Patients hospitalized at the Bordeaux University Hospital or one of the hospital of the territorial organization ;
- Patients hospitalized between 01/01/2022 and 31/12/2024 ;
Indicator 1: "antibiotic treatments of more than 7 days without justifications"
- Patients with of a hospitalization of more than 24 hours;
- Patients with urinary or respiratory infections on admission or during the hospitalization (including sepsis related to urinary or respiratory infection);
- Patients with a prescription for at least one antibiotic, initiated on admission or during the hospitalization, for more than 7 days including the hospital prescription AND the discharge prescription
Indicator 2: "surgical antibiotic prophylaxis lasting more than 24 hours"
- Patients with surgery requiring an antibiotic prophylaxis
- Patients having received antibiotic prophylaxis
Exclusion Criteria:
- Patients not hospitalized at the Bordeaux University Hospital or one of the hospital of the territorial organization.
- Patients whose medical and administrative data are not available in an electronic format in the hospital information system;
- Patients who have refused the secondary use of their data for research purpose
Indicator 1: "Indicator of antibiotic treatments of more than 7 days without justifications"
- Patients with another concomitant infectious pathology
- Patient with pulmonary or urinary tuberculosis
Indicator 2: "surgical antibiotic prophylaxis lasting more than 24 hours"
- Patients without any surgery or with surgery for which antibiotic prophylaxis is not required
- Patients without antibiotic prophylaxis
Study Plan
How is the study designed?
Design Details
- Observational Models: Other
- Time Perspectives: Retrospective
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Patient who received antibiotic prophylaxis
Patient who received antibiotic prophylaxis to assess appropriateness and consumption of treatment.
|
The system will identify inappropriate antibiotic prescriptions.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Sensitivity of the automatic tool to identify inappropriate antibiotic prescriptions compared to classical practices audits (gold standard).
Time Frame: Between January 2021 and December 2024
|
Indicator "inappropriate treatment lasting more than 7 days": antibiotic treatment initiated or continued more than 7 days in clinical situations (urinary and respiratory infections) where a shorter treatment is recommended Indicator "surgical antibiotic prophylaxis lasting more than 24 hours": antibiotic given for a more than 24 hours for a surgical procedure requiring antibiotic prophylaxis The gold standard is the judgement of prescription appropriateness by infectious diseases experts.
The gold standard will be measured independently from the automatic tool.
Data will be manually extracted from patient electronic health record and assessed, independently, by two infectious diseases specialists to identify inappropriate prescriptions.
In case of disagreement, an expert committee will be convened.
|
Between January 2021 and December 2024
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Metrological performances of each indicator
Time Frame: Between January 2021 and December 2023
|
specificity , positive and negative predictive values to identify inappropriate prescriptions will be compared to gold standard (practices audits)
|
Between January 2021 and December 2023
|
Number of responses done by the system
Time Frame: Between December 2022 and December 2024
|
The number and the content of responses: acknowledgment of inappropriateness or justification of the prescription The number of alerts without responses from the prescriber.
|
Between December 2022 and December 2024
|
Number of response with justification of the prescription
Time Frame: Between December 2022 and December 2024
|
The number and the content of responses: acknowledgment of inappropriateness or justification of the prescription The number of alerts without responses from the prescriber.
|
Between December 2022 and December 2024
|
Number of alerts without responses from the prescriber
Time Frame: Between December 2022 and December 2024
|
The number and the content of responses: acknowledgment of inappropriateness or justification of the prescription The number of alerts without responses from the prescriber.
|
Between December 2022 and December 2024
|
Evaluate the score with scale MAUQ_E
Time Frame: Between June 2023 and December 2024
|
The usability of the tool will be assessed with the mHealth App Usability Questionnaire ( Zhou L, Bao J, Setiawan A, Saptono A, Parmanto B, (2019), "The mHealth App Usability Questionnaire (MAUQ): Development and Validation Study", JMIR mHealth and uHealth, 7(4):e11500. DOI: 10.2196/11500. PMID: 30973342). This score evaluate the ease of use of Interface Items of Scale are from 1 to 7 : 1 - strongly disagree, 2 - disagree, 3 - somewhat disagree, 4 - neither , agree nor disagree, 5 - somewhat agree, 6 - agree, 7 - strongly agree. |
Between June 2023 and December 2024
|
Evaluate the score with scale MAUQ_I
Time Frame: Between June 2023 and December 2024
|
The usability of the tool will be assessed with the mHealth App Usability Questionnaire ( Zhou L, Bao J, Setiawan A, Saptono A, Parmanto B, (2019), "The mHealth App Usability Questionnaire (MAUQ): Development and Validation Study", JMIR mHealth and uHealth, 7(4):e11500. DOI: 10.2196/11500. PMID: 30973342). This score evaluate the satisfaction use of Interface Items of Scale are from 1 to 7 : 1 - strongly disagree, 2 - disagree, 3 - somewhat disagree, 4 - neither , agree nor disagree, 5 - somewhat agree, 6 - agree, 7 - strongly agree. |
Between June 2023 and December 2024
|
Evaluate the score with scale MAUQ_U
Time Frame: Between June 2023 and December 2024
|
The usability of the tool will be assessed with the mHealth App Usability Questionnaire ( Zhou L, Bao J, Setiawan A, Saptono A, Parmanto B, (2019), "The mHealth App Usability Questionnaire (MAUQ): Development and Validation Study", JMIR mHealth and uHealth, 7(4):e11500. DOI: 10.2196/11500. PMID: 30973342). This score evaluate the usefulness. Items of Scale are from 1 to 7 : 1 - strongly disagree, 2 - disagree, 3 - somewhat disagree, 4 - neither , agree nor disagree, 5 - somewhat agree, 6 - agree, 7 - strongly agree. |
Between June 2023 and December 2024
|
Number of inappropriate antibiotic prescriptions
Time Frame: Between April 2023 and December 2024
|
Changes in the proportion of inappropriate prescriptions will be assessed 4 months after implementation of the automatic tool and compared with the pre-implementation period
|
Between April 2023 and December 2024
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Frantz THIESSARD, MD, PhD, University Hospital, Bordeaux
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- CHUBX 2018/69
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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