Evidence map›Paper›PMID 38053212›Full record

ArticleAntimicrobial resistance and infection control2023

Gamified antimicrobial decision support app (GADSA) changes antibiotics prescription behaviour in surgeons in Nigeria: a hospital-based pilot study.

Susanne Luedtke, Caroline Wood, Olajumoke Olufemi, Patrick Okonji, Eneyi E Kpokiri, Anwar Musah, Funmi Bammeke, Bamidele Mutiu, Rufus Ojewola, Olufemi Bankole and 13 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Antimicrobial resistance and infection control, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
1.3field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors at 7 institutions in 3 countries.

Susanne LuedtkeUCL IRDR Centre for Digital Public Health in Emergencies, University College London, Gower Street, London, WC1E 6BT, UK. luedtke.susanne@gmail.com.
Caroline WoodUCL IRDR Centre for Digital Public Health in Emergencies, University College London, Gower Street, London, WC1E 6BT, UK.
Olajumoke OlufemiDepartment of Medical Microbiology, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria.
Patrick OkonjiDepartment of Medical Microbiology, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria.
Eneyi E KpokiriFaculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
Anwar MusahUCL IRDR Centre for Digital Public Health in Emergencies, University College London, Gower Street, London, WC1E 6BT, UK.
Funmi BammekeDepartment of Sociology, University of Lagos, Lagos, Nigeria.
Bamidele MutiuDepartment of Medical Microbiology, Lagos State University College of Medicine/Lagos State University Teaching Hospital, Lagos, Nigeria.
Rufus OjewolaUrology Unit, Department of Surgery, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria.
Olufemi BankoleNeurosurgery Unit, Department of Surgery, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria.
Adesoji AdemuyiwaPaediatric Surgery Unit, Department of Surgery, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria.
Chibuzo EkumankamaDepartment of Ophthalmology, Lagos State University Teaching Hospital, Lagos, Nigeria.
Ayibanoah TheophilusDepartment of Pharmacy, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria.
Neni Aworabhi-OkiDepartment of Surgery, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria.
Laura ShallcrossInstitute of Infectious Diseases Informatics, University College London, London, UK.
Andreea MolnarSchool of Software and Electrical Engineering, Swinburne University of Technology, Melbourne, Australia.
Sue WisemanUCL IRDR Centre for Digital Public Health in Emergencies, University College London, Gower Street, London, WC1E 6BT, UK.
Andrew HaywardInstitute of Epidemiology and Public Health, University College London, London, UK.
Georgiana BirjovanuUCL IRDR Centre for Digital Public Health in Emergencies, University College London, Gower Street, London, WC1E 6BT, UK.
Carmen LefevreUCL Centre for Behaviour Change, University College London, London, UK.
Stylianos PetrouUCL IRDR Centre for Digital Public Health in Emergencies, University College London, Gower Street, London, WC1E 6BT, UK.
Folasade Ogunsola *Department of Medical Microbiology, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria.
Patty Kostkova *UCL IRDR Centre for Digital Public Health in Emergencies, University College London, Gower Street, London, WC1E 6BT, UK.
University College London · GBLagos University Teaching Hospital · NGUniversity of Lagos · NGLagos State University Teaching Hospital · NGNiger Delta University · NGLondon School of Hygiene & Tropical Medicine · GBSwinburne University of Technology · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsSurgical Antibiotic Prophylaxis (SAP) in Nigeria is often not evidence based. The aim of this study is to test if the GADSA application can change prescription behaviour of surgeons in Nigeria. In addition, the study aims to identify AMS strategies and policies for the future.

methodsThe GADSA gamified decision support app uses WHO and Sanford prescribing guidelines to deliver real-time persuasive technology feedback to surgeons through an interactive mentor. The app can advise on whether clinician's decisions align with SAP recommendations and provides the opportunity for clinicians to make adjustments. Twenty surgeons actively participated in a 6-month pilot study in three hospitals in Nigeria. The surgeons determined the risk of infection of a surgical procedure, and the need, type and duration of SAP. The study used a longitudinal approach to test whether the GADSA app significantly changed prescribing behaviour of participating surgeons by analysing the reported prescription decisions within the app.

results321 SAP prescriptions were recorded. Concerning the surgical risk decision, 12% of surgeons changed their decision to be in line with guidelines after app feedback (p < 0.001) and 10% of surgeons changed their decision about the need for SAP (p = 0.0035) to align with guidelines. The change in decision making for SAP use in terms of "type" and "duration" to align with guidelines was similar with 6% and 5% respectively (both p-values < 0.001).

conclusionThis study suggests that the GADSA app, with its game based and feedback feature, could significantly change prescribing behaviour at the point of care in an African setting, which could help tackle the global challenge of antibiotic resistance.

Indexed as

Anti-Infective AgentsMobile ApplicationsSurgeonsAnti-Bacterial AgentsGuideline AdherenceHospitalsHumansNigeriaPilot ProjectsPrescriptionsAnti-Bacterial AgentsAnti-Infective AgentsAfricaAntibioticsGuideline adherenceNigeriaPerioperative antibiotic prophylaxisPrescribing

Identifiers

PMID38053212
PMCPMC10699010
OpenAlexW4389396027

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.