Approaches to promoting the appropriate use of antibiotics through hospital electronic prescribing systems: a scoping review

摘要: Objective To identify approaches of using stand-alone and more integrated hospital ePrescribing systems to promote support the appropriate use antibiotics, gaps in order inform future efforts this area. Methods A systematic scoping review empirical literature from 1997 until 2015, searching following databases: MEDLINE, EMBASE, Cochrane Database Systematic Reviews, Google Scholar, Clinical Trials, International Standard Randomised Controlled Trial Number Registry, Economic Evaluation database Prospective Register Reviews. Search terms related different components systems, settings antimicrobial stewardship. Two reviewers independently screened papers mutually agreed for inclusion. We undertook an interpretive synthesis. Key findings We identified 143 papers. The majority these were single-centre observational studies North American with a wide range system functionalities. Most evidence computerised decision (CDS) physician entry (CPOE) functionalities, which many extensively customised. also found some limited work surrounding integration laboratory results, pharmacy organisational surveillance. Outcomes examined included healthcare professional performance, patient outcomes health economic evaluations. at times conflicting conclusions effectiveness, may be due heterogeneity populations, technologies studied. Reports unintended consequences limited. Conclusions Interventions are centred on CPOE CDS, but include additional functionality aiming various facets medicines management process. Wider dimensions appear important supporting adoption. Evaluations should consider processes, clinical, safety generate generalisable insights into safety, effectiveness cost-effectiveness.