Electronic Clinical Decision Support Tools to Manage Patients with Lower Respiratory Tract Infection: Clinicians' Perspectives in Sri Lanka.

IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH American Journal of Tropical Medicine and Hygiene Pub Date : 2025-03-11 DOI:10.4269/ajtmh.24-0576
Warsha De Zoysa, Dhammika Palangasinghe, Champica Bodinayake, Ajith Nagahawatte, Jayani Gamage, Maria Iglesias-Ussel, Stefany Olague, Christina Galdieri, Ruvini Kurukulasooriya, Senali Weerasinghe, Madureka Premamali, James Ngocho, Armstrong Obale, Hrishikesh Chakraborty, Truls Ostbye, Susanna Naggie, Christopher W Woods, Evan Myers, Melissa H Watt, L Gayani Tillekeratne
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Abstract

In low-resource settings, providers often manage lower respiratory tract infections (LRTIs) without diagnostic tests, which may cause antibacterial overuse. Electronic clinical decision support tools (eCDSTs) can support evidence-based decision-making and judicious use of antibacterials. This study aimed to explore the potential of an eCDST to help providers in Sri Lanka effectively manage LRTI. Semi-structured interviews were conducted with 15 clinicians, including 10 males and five females, with an average of 11.6 years (range: 4-25 years) of clinical practice. The interview guide covered clinicians' interest in an eCDST to manage LRTI and their feedback regarding the desired features of such a tool. Interviews were audio-recorded, transcribed, and coded for themes related to: interest in an eCDST for LRTI, desired tool capabilities, development concerns, and tool design characteristics. All expressed interest in incorporating eCDSTs into their practice. However, the majority emphasized that clinical judgment must supersede recommendations from an eCDST. Four themes emerged regarding desired tool capabilities: information about the pathogen, treatment recommendations, severity of the LRTI, and monitoring of patient progress. Six themes emerged regarding tool development considerations: validated algorithms, regional specificity, seasonality, inclusion of patient's risk factors, scalability, and the importance of updated and locally relevant recommendations. Participants stressed that the tool design should be simple, timesaving, and internet-independent. Electronic clinical decision support tools are capable of improving patient care and reduce antibiotic overuse, which may impact downstream antibacterial resistance. Future research should develop an eCDST for LRTI with local input and evaluate its impact on appropriate antibacterial use and patient outcomes.

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来源期刊
American Journal of Tropical Medicine and Hygiene
American Journal of Tropical Medicine and Hygiene 医学-公共卫生、环境卫生与职业卫生
CiteScore
6.20
自引率
3.00%
发文量
508
审稿时长
3 months
期刊介绍: The American Journal of Tropical Medicine and Hygiene, established in 1921, is published monthly by the American Society of Tropical Medicine and Hygiene. It is among the top-ranked tropical medicine journals in the world publishing original scientific articles and the latest science covering new research with an emphasis on population, clinical and laboratory science and the application of technology in the fields of tropical medicine, parasitology, immunology, infectious diseases, epidemiology, basic and molecular biology, virology and international medicine. The Journal publishes unsolicited peer-reviewed manuscripts, review articles, short reports, images in Clinical Tropical Medicine, case studies, reports on the efficacy of new drugs and methods of treatment, prevention and control methodologies,new testing methods and equipment, book reports and Letters to the Editor. Topics range from applied epidemiology in such relevant areas as AIDS to the molecular biology of vaccine development. The Journal is of interest to epidemiologists, parasitologists, virologists, clinicians, entomologists and public health officials who are concerned with health issues of the tropics, developing nations and emerging infectious diseases. Major granting institutions including philanthropic and governmental institutions active in the public health field, and medical and scientific libraries throughout the world purchase the Journal. Two or more supplements to the Journal on topics of special interest are published annually. These supplements represent comprehensive and multidisciplinary discussions of issues of concern to tropical disease specialists and health issues of developing countries
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