Evaluation of a Smartphone Decision-Support Tool for Diarrheal Disease Management in a Resource-Limited Setting.
The emergence of mobile technology offers new opportunities to improve clinical guideline adherence in resource-limited settings. We conducted a clinical pilot study in rural Bangladesh to evaluate the impact of a smartphone adaptation of the World Health Organization (WHO) diarrheal disease managem...
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ftdoajarticles:oai:doaj.org/article:62303789dfd4409792ab2235efb63b82 2023-05-15T15:15:18+02:00 Evaluation of a Smartphone Decision-Support Tool for Diarrheal Disease Management in a Resource-Limited Setting. Farhana Haque Robyn L Ball Selina Khatun Mujaddeed Ahmed Saraswati Kache Mohammod Jobayer Chisti Shafiqul Alam Sarker Stace D Maples Dane Pieri Teja Vardhan Korrapati Clea Sarnquist Nancy Federspiel Muhammad Waliur Rahman Jason R Andrews Mahmudur Rahman Eric Jorge Nelson 2017-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0005290 https://doaj.org/article/62303789dfd4409792ab2235efb63b82 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC5283765?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005290 https://doaj.org/article/62303789dfd4409792ab2235efb63b82 PLoS Neglected Tropical Diseases, Vol 11, Iss 1, p e0005290 (2017) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2017 ftdoajarticles https://doi.org/10.1371/journal.pntd.0005290 2022-12-31T12:07:18Z The emergence of mobile technology offers new opportunities to improve clinical guideline adherence in resource-limited settings. We conducted a clinical pilot study in rural Bangladesh to evaluate the impact of a smartphone adaptation of the World Health Organization (WHO) diarrheal disease management guidelines, including a modality for age-based weight estimation. Software development was guided by end-user input and evaluated in a resource-limited district and sub-district hospital during the fall 2015 cholera season; both hospitals lacked scales which necessitated weight estimation. The study consisted of a 6 week pre-intervention and 6 week intervention period with a 10-day post-discharge follow-up. Standard of care was maintained throughout the study with the exception that admitting clinicians used the tool during the intervention. Inclusion criteria were patients two months of age and older with uncomplicated diarrheal disease. The primary outcome was adherence to guidelines for prescriptions of intravenous (IV) fluids, antibiotics and zinc. A total of 841 patients were enrolled (325 pre-intervention; 516 intervention). During the intervention, the proportion of prescriptions for IV fluids decreased at the district and sub-district hospitals (both p < 0.001) with risk ratios (RRs) of 0.5 and 0.2, respectively. However, when IV fluids were prescribed, the volume better adhered to recommendations. The proportion of prescriptions for the recommended antibiotic azithromycin increased (p < 0.001 district; p = 0.035 sub-district) with RRs of 6.9 (district) and 1.6 (sub-district) while prescriptions for other antibiotics decreased; zinc adherence increased. Limitations included an absence of a concurrent control group and no independent dehydration assessment during the pre-intervention. Despite limitations, opportunities were identified to improve clinical care, including better assessment, weight estimation, and fluid/ antibiotic selection. These findings demonstrate that a smartphone-based tool can ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 11 1 e0005290 |
institution |
Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Farhana Haque Robyn L Ball Selina Khatun Mujaddeed Ahmed Saraswati Kache Mohammod Jobayer Chisti Shafiqul Alam Sarker Stace D Maples Dane Pieri Teja Vardhan Korrapati Clea Sarnquist Nancy Federspiel Muhammad Waliur Rahman Jason R Andrews Mahmudur Rahman Eric Jorge Nelson Evaluation of a Smartphone Decision-Support Tool for Diarrheal Disease Management in a Resource-Limited Setting. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
The emergence of mobile technology offers new opportunities to improve clinical guideline adherence in resource-limited settings. We conducted a clinical pilot study in rural Bangladesh to evaluate the impact of a smartphone adaptation of the World Health Organization (WHO) diarrheal disease management guidelines, including a modality for age-based weight estimation. Software development was guided by end-user input and evaluated in a resource-limited district and sub-district hospital during the fall 2015 cholera season; both hospitals lacked scales which necessitated weight estimation. The study consisted of a 6 week pre-intervention and 6 week intervention period with a 10-day post-discharge follow-up. Standard of care was maintained throughout the study with the exception that admitting clinicians used the tool during the intervention. Inclusion criteria were patients two months of age and older with uncomplicated diarrheal disease. The primary outcome was adherence to guidelines for prescriptions of intravenous (IV) fluids, antibiotics and zinc. A total of 841 patients were enrolled (325 pre-intervention; 516 intervention). During the intervention, the proportion of prescriptions for IV fluids decreased at the district and sub-district hospitals (both p < 0.001) with risk ratios (RRs) of 0.5 and 0.2, respectively. However, when IV fluids were prescribed, the volume better adhered to recommendations. The proportion of prescriptions for the recommended antibiotic azithromycin increased (p < 0.001 district; p = 0.035 sub-district) with RRs of 6.9 (district) and 1.6 (sub-district) while prescriptions for other antibiotics decreased; zinc adherence increased. Limitations included an absence of a concurrent control group and no independent dehydration assessment during the pre-intervention. Despite limitations, opportunities were identified to improve clinical care, including better assessment, weight estimation, and fluid/ antibiotic selection. These findings demonstrate that a smartphone-based tool can ... |
format |
Article in Journal/Newspaper |
author |
Farhana Haque Robyn L Ball Selina Khatun Mujaddeed Ahmed Saraswati Kache Mohammod Jobayer Chisti Shafiqul Alam Sarker Stace D Maples Dane Pieri Teja Vardhan Korrapati Clea Sarnquist Nancy Federspiel Muhammad Waliur Rahman Jason R Andrews Mahmudur Rahman Eric Jorge Nelson |
author_facet |
Farhana Haque Robyn L Ball Selina Khatun Mujaddeed Ahmed Saraswati Kache Mohammod Jobayer Chisti Shafiqul Alam Sarker Stace D Maples Dane Pieri Teja Vardhan Korrapati Clea Sarnquist Nancy Federspiel Muhammad Waliur Rahman Jason R Andrews Mahmudur Rahman Eric Jorge Nelson |
author_sort |
Farhana Haque |
title |
Evaluation of a Smartphone Decision-Support Tool for Diarrheal Disease Management in a Resource-Limited Setting. |
title_short |
Evaluation of a Smartphone Decision-Support Tool for Diarrheal Disease Management in a Resource-Limited Setting. |
title_full |
Evaluation of a Smartphone Decision-Support Tool for Diarrheal Disease Management in a Resource-Limited Setting. |
title_fullStr |
Evaluation of a Smartphone Decision-Support Tool for Diarrheal Disease Management in a Resource-Limited Setting. |
title_full_unstemmed |
Evaluation of a Smartphone Decision-Support Tool for Diarrheal Disease Management in a Resource-Limited Setting. |
title_sort |
evaluation of a smartphone decision-support tool for diarrheal disease management in a resource-limited setting. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2017 |
url |
https://doi.org/10.1371/journal.pntd.0005290 https://doaj.org/article/62303789dfd4409792ab2235efb63b82 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 11, Iss 1, p e0005290 (2017) |
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http://europepmc.org/articles/PMC5283765?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005290 https://doaj.org/article/62303789dfd4409792ab2235efb63b82 |
op_doi |
https://doi.org/10.1371/journal.pntd.0005290 |
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PLOS Neglected Tropical Diseases |
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11 |
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1 |
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e0005290 |
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