Effect of Smartphone App–Based Education on Clinician Prescribing Habits in a Learning Health Care System

• DOI: 10.1001/jamanetworkopen.2022.23099
• Publication Date: 2022-07-26T17:05:49Z
• Authors: Matthew D. McEvoy; Mary Lynn Dear; Reagan Buie; David A. Edwards; Tyler W. Barrett; Brian Allen; Amy C. Robertson; Leslie C. Fowler; Cassandra Hennessy; Bonnie M. Miller; Kim V. Garvey; Robert P. Bland; Geoffrey M. Fleming; Don Moore; Todd W. Rice; Gordon R. Bernard; Christopher J. Li...; ; Robert Dittus; Shon Dwyer; Robert Freundlich; Cheryl Gatto; Frank Harrell; Paul Harris; Tina Hartert; Jim Hayman; Catherine Ivory; Kevin Johnson; Ruth Kleinpell; Sunil Kripalani; Lee Ann Liska; Patrick Luther; Jay Morrison; Thomas Nantais; Mariann Piano; Jill Pulley; Kris Rehm; Russell Rothman; Matthew Semler; Robin Steaban; Consuelo Wilkins; Adam Wright; Autumn Zuckerman; Michael Costello; R. Scott Frankenf...; Alexander Hawkins; Sterling Haring; Jason Hessler; Elizabeth Huggins; Carin McAbee; Puneet Mishra; Hayley Rector; Jennifer Slayton; Irving Zamora
• Keywords: Crossover study

Effective methods for engaging clinicians in continuing education learning-based practice improvement remain unknown.To determine whether a smartphone-based app using spaced with retrieval is an effective method to increase evidence-based practice.A prospective, unblinded, single-center, crossover randomized clinical trial was conducted at single academic medical center from January 6 April 24, 2020. Vanderbilt University Medical Center prescribing intravenous fluids were invited participate this study.All received two 4-week modules: 1 on and opioid nonopioid medications (counterbalancing measure), over 12-week period. The order of delivery 1:1 such that group the fluid management module first, followed by pain after break, other break.The primary outcome clinician behavior concerning inpatient setting medication discharge hospital.A total 354 participants enrolled randomized, 177 (fluid then education) 2 (pain education). During overall study period, 16 868 questions sent 349 learners, 11 783 (70.0%) being opened: 10 885 (92.4%) those opened answered 7175 (65.9%) correctly. differences between groups changed significantly time, indicated significant interaction educational intervention time (P = .002). Briefly, baseline evidence-concordant IV ordered 7.2% less frequently than (95% CI, -19.2% 4.9%). This reversed training 4% higher -8.2% 16.0%) 2, more doubling odds ordering (OR, 2.56, 95% 0.80-8.21). Postintervention, all gains had been frequent (-9.5%, -21.6% 2.7%). There no measurable change behaviors any point.In trial, use smartphone learning modules resulted statistically short-term some behaviors. However, effect not sustained long-term. Additional research needed understand how sustain improvements care as result continuous professional development institutional level.ClinicalTrials.gov Identifier: NCT03771482.