Evaluating the Impact of a Digital Prescription Support System on Antibiotic Use in Belgian Primary Care A Stepped-Wedge Cluster Randomized Trial

What this Trial Is About

Inappropriate antibiotic prescribing in primary care contributes significantly to antimicrobial resistance. This trial evaluates a digital Prescription Support System PSS designed to help Belgian general practitioners follow national antimicrobial guidelines more closely during patient consultations. The study uses a stepped-wedge cluster randomized design where general practices gradually transition from usual care to using the PSS, allowing comparison of prescribing patterns over time. The PSS integrates guideline-based recommendations from the Belgian BAPCOC guidelines into existing electronic health records. It presents advice through a decision tree for common infections and guides antibiotic choice, dosage, duration, and situations where antibiotics are not recommended. Practices start without access to the PSS and switch to using it in four sequential steps lasting three months each, after which they retain access for the study duration. Participants are general practices whose prescribing data are collected quarterly via the Belgian Antibiotic Barometer, ensuring anonymity and data security. Researchers will measure antibiotic prescribing rates and monitor PSS usage, usability, acceptability by clinicians, and any unintended effects on workflow. The study lasts up to 12 months per practice, aiming to inform broader implementation and optimization of the PSS in Belgian primary care.

Prescription Support System for Antimicrobial Use in Belgian Primary Care