CDS tools reduce unnecessary antibiotic use, strep tests

Incorporating clinical decision support predictive tools into electronic health record use can "significantly" decrease the use of antibiotics for respiratory tract infections, according to a study published this week in JAMA Internal Medicine.

The researchers, from Hofstra North Shore-Long Island Jewish School of Medicine, noted that CDS tools hold promise in reducing costs and overtreatment, but that this has not been shown in clinical trials. They examined 168 primary care providers in two urban settings. The intervention group had two clinical prediction rules on respiratory tract infections--one on streptococcal pharyngitis and one on pneumonia--integrated into their EHRs.

The researchers found that almost two thirds of physicians in the intervention group (62.8 percent) adopted the CDS tools; in more than half (57.5 percent) of the relevant encounters, the researchers completed the tools' risk assessment and generated a risk score. As a result, providers in the intervention group were "significantly" less likely to order an antibiotic or a rapid strep test.  

"We believe our results indicate that providers may have perceived the tool as being helpful with the clinical diagnosis of pharyngitis and pneumonia, enhancing clinical work flow and improving patient care, which are hallmarks of [clinical decision support] interventions that are well received by physicians," the researchers said, according to Medscape Medical News.

Other studies have shown that CDS tools can improve patient care and reduce unnecessary tests, but that too many of them can have an adverse effect.

To learn more:
- here's the study abstract
- read the Medscape Medical News article