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Clinical pathway and monthly feedback improve adherence to antibiotic guideline recommendations for community-acquired pneumonia


Almatar, M and Peterson, GM and Thompson, A and McKenzie, D and Anderson, T and Zaidi, STR, Clinical pathway and monthly feedback improve adherence to antibiotic guideline recommendations for community-acquired pneumonia, PLoS One, 11, (7) Article e0159467. ISSN 1932-6203 (2016) [Refereed Article]


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Copyright The Authors Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0)

DOI: doi:10.1371/journal.pone.0159467


Background: Compliance with community-acquired pneumonia (CAP) guidelines remains poor despite a substantial body of evidence indicating that guideline-concordant care improves patient outcomes. The aim of this study was to compare the relative effectiveness of a general educational and a targeted emergency department intervention on improving physicians’ concordance with CAP guidelines.

Methods: Two distinct interventions were implemented over specific time periods. The first intervention was educational, focusing on the development of local CAP guidelines and their dissemination through hospital-wide educational programmes. The second intervention was a targeted one for the emergency department, where a clinical pathway for the initial management of CAP patients was introduced, followed by monthly feedback to the emergency department (ED) physicians about concordance rates with the guidelines. Data on the concordance rate to CAP guidelines was collected from a retrospective chart review.

Results: A total of 398 eligible patient records were reviewed to measure concordance to CAP guidelines over the study period. Concordance rates during the baseline and educational intervention periods were similar (28.1% vs. 31.2%; p > 0.05). Significantly more patients were treated in accordance with the CAP guidelines after the ED focused intervention when compared to the baseline (61.5% vs. 28.1%; p < 0.05) or educational period (61.5% vs. 31.2%; p < 0.05).

Conclusions: A targeted intervention with a CAP clinical pathway and monthly feedback was a successful strategy to increase adherence to empirical antibiotic recommendations in CAP guidelines.

Item Details

Item Type:Refereed Article
Keywords:guidelines, concordance, physicians, pneumonia, antibiotics, pathway
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Infectious diseases
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Almatar, M (Mr Maher Almatar)
UTAS Author:Peterson, GM (Professor Gregory Peterson)
UTAS Author:Thompson, A (Mr Angus Thompson)
UTAS Author:Zaidi, STR (Dr Tabish Razi Zaidi)
ID Code:110416
Year Published:2016
Web of Science® Times Cited:16
Deposited By:Pharmacy
Deposited On:2016-07-27
Last Modified:2022-08-29
Downloads:198 View Download Statistics

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