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SALT LAKE CITY -- TheraDoc, Inc., a medical informatics company specializing in expert clinical decision support software, provided the technology for a study published in the Journal of the American Medical Association (JAMA. 2005; 294:2305-2314) on Nov. 9, 2005. Funded by the Centers for Disease Control and Prevention (CDC), the randomized study targeted an increasing threat to public healthÂ Â the misuse of antibiotics for viral infections, fostering the proliferation of antibiotic-resistant organisms.
Researcher Matthew H. Samore, MD, of the University of Utah and colleagues from Idaho and Utah, proved the value of clinical decision support systems (CDSS) in reducing overall antibiotic use. They also established that CDSS could improve appropriate antibiotic prescribing for acute respiratory tract infections. Conducted from January 2002 to September 2003 in 12 rural communities in Utah and Idaho, the study included 407,460 area residents and 334 primary care clinicians who documented more than 13,000 acute respiratory tract infections.
TheraDoc modified its commercially available Antibiotic AssistantÂ® with a customized algorithm designed specifically for this study. Before treating a patient with a suspected acute respiratory tract infection, clinicians in six rural communities entered patient data into a handheld personal digital assistant (PDA) running TheraDoc software. By combining the patient data with evidence-based medical knowledge relating to acute respiratory tract infections, TheraDoc's clinical decision support software generated patient-specific diagnostic and therapeutic recommendations.
With detailed information placed at their fingertips participating physicians aided by TheraDoc's software made better-informed and more-appropriate treatment decisions, decreasing inappropriate antibiotic prescribing by 32 percent. Clinicians in a comparative group of another six communities were supported only by a community intervention campaign that was concurrently launched to educate residents about the hazards of misusing antibiotics. The comparative group did not have access to a CDSS and realized only a 5 percent prescription reduction.
TheraDoc's unique Web and PDA-based clinical decision support software is purchased by hospitals across the country to aid clinician workflow and decision-making while improving the safety and quality of patient care. Researchers familiar with TheraDoc capabilities have utilized TheraDoc software in several academic studies in the past, including the following:
- In 2004, to support an assessment of local antimicrobial resistance measures (ALARM), TheraDoc provided custom configured software to ICUs in approximately 40 hospitals across the country. Coordinated by FJ Rodino Healthcare Group and funded by Irish pharmaceuticals company, Elan Corp., the project studied local patterns of antibiotic resistance to determine the best empiric therapy for patients suspected of having ventilator-associated pneumonia (VAP). TheraDoc software enabled data collection on Palm i705s for more than 300 patients at the bedside, which was then transmitted in real-time to the study database.Â
- In 2002, the multi-year IMPART (Inter-Mountain Project on Antimicrobial Resistance and Therapy) project, also funded by CDC, was designed to track the spread of antibiotic-resistant bacteria and improve use of antibiotics in rural areas of Idaho and Utah. TheraDoc custom configured its Antibiotic Assistant for data collection and analysis.
- In 2000, to improve infection control practices and antibiotic prescribing, several rural community hospitals began participating in the Rural Antibiotic Decision-Support and Resistance Project (RADAR), funded by CMS (Centers for Medicare & Medicaid Services). In this study, TheraDoc software was used after the fact to analyze prescribing patterns. This study revealed that 57 percent of antibiotic orders in small rural hospitals included in the study group had disparities between antibiotics ordered for patients and those recommended by evidence, guidelines and expert opinion.
"We are always pleased to partner with the CDC to support valuable academic research," stated Stanley Pestotnik, TheraDoc's co-founder and president. "This study's findings truly validate the benefits provided by our clinical decision-support software, which is designed to help hospitals and clinicians address the growing problem of antibiotic-resistant organisms."
Source: TheraDoc, Inc.