The Kaiser Permanente research team used a pragmatic stepped-wedge cluster randomized study design. From September 2014 through April 2015, researchers tracked nearly 22,000 initial acute sinusitis encounters in adults at primary and urgent care offices. They studied the effect of a computer-based intervention on antibiotic prescription patterns. The intervention included computer alerts to inform doctors when antibiotics may not be the best course of treatment.
The study shows that clinical decision support was associated with a 22 percent decrease of in antibiotic use post-intervention, but the absolute reduction was only 2 percent.
Additionally, researchers found that provider education had a large effect initially, but it was not sustained over the study period.
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