Impact Evaluation of a Prescription Search Support (PSS) for Antimicrobials Using a Stepped-Wedge Cluster Randomized Design in Belgian Primary Care

What this Trial Is About

Inappropriate antibiotic prescribing in primary care contributes to antimicrobial resistance, especially when antibiotics are used for infections that usually resolve on their own. This research aims to evaluate a digital Prescription Support System (PSS) designed to help general practitioners in Belgium follow national guidelines for antimicrobial use during patient visits. The study uses a stepped-wedge cluster randomized design where general practices transition from usual care to using the PSS over four steps. The PSS integrates the Belgian BAPCOC guidelines into a user-friendly decision tree within electronic health records. It provides recommendations on antibiotic choice, dosage, duration, and when antibiotics are not needed for common infections seen in ambulatory care. Practices start with usual care and then sequentially gain access to the PSS, maintaining use for the remainder of the study. This digital tool aims to support prescribing decisions during routine consultations. Participants include general practices that use compatible electronic health records and consent to participate. The study monitors antibiotic prescribing rates quarterly using data from the Belgian Antibiotic Barometer for up to 12 months per practice. Researchers also assess the PSS's usability, acceptability, intensity of use, and any unintended effects reported by clinicians or observed in system data. Data privacy is ensured through pseudonymization and secure handling. Results will guide future improvements and broader implementation of the PSS in Belgian primary care.

Prescription Support System for Antimicrobial Use in Belgian Primary Care