• Title Reducing antibiotic abuse at the primary care level using locally adapted, digitally delivered, clinical decision support tool: a pilot, intervention study in India
  • Granting Agency McGill Interdisciplinary Initiative in Infection and Immunity (MI4)
  • Period 1 May 2023 – 30 April 2025
  • Amount $150,000 CAD [with Dr. Samira Abbasgholizadeh Rahimi, McGill University]

Antibiotic abuse is a major concern at the primary care level in low- and middle-income countries, and the COVID pandemic has aggravated this practice. WHO just published the AWaRe antibiotic book, which provides best practices in clinical assessment, diagnosis and treatment of various infections. But the WHO antibiotic book is unlikely to get scaled-up, unless it is adapted to the local context, translated into regional languages, and delivered effectively to primary care physicians via decision aids, enhanced by shared decision making. We propose to evaluate, using a before and after study, whether a locally adapted, digitally delivered, clinical decision support tool and training intervention can reduce antibiotic use among private primary care providers in Patna, India. Our study will rely on the standardized patient methodology that we have successfully used in many countries. Our findings will provide preliminary evidence on private providers’ antibiotic prescription practices, and effectiveness of a locally adapted, digitally delivered, decision tool and training intervention in shared decision making and reducing antibiotic use among private providers. Our results will inform antibiotic stewardship programs and will set the stage for a future randomized controlled trial. Such work will have great relevance in lower-income as well as high-income nations.