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Researchers at Imperial’s Centre for Infection Prevention and Management, in collaboration with clinicians from Imperial College Healthcare NHS Trust, have created an interactive game to improve antibiotic prescribing in acute care.

Increasing antimicrobial resistance has been identified as a global threat to health, and a variety of measures to encourage prudent use of antibiotics have been implemented with varying success. Whilst prescriber knowledge and skills are important, attention to behavioural and social aspects in prescribing are essential to sustain any improvement initiatives.


Virtual patient to be diagnosed

The On call: antibiotics app allows doctors, nurses and pharmacists to manage a series of virtual patients attending a simulated hospital. Working against the clock, players receive information about symptoms experienced by patients and are required to diagnose and manage the cases.

To be successful, players have to make optimal use of antibiotics and antibiotic prescribing behaviours. The game provides immediate feedback on players’ performance and decisions, their clinical accuracy and impact on other professionals and the wider hospital environment.

Enrique Castro Sánchez, Lead Research Nurse at the Health Protection Research Unit in Healthcare-Associated Infection and Antimicrobial Resistance at Imperial, who led the project said: ‘The idea for the game was influenced by the increasing emergence of healthcare games, as well as the dramatic surge in the use of smartphones and similar devices in medicine. I thought that tapping into the potential of gamification would help us maintain interest and engagement in appropriate prescribing behaviours.’

The team of researchers, which included doctors and pharmacists from the College and Trust, worked in collaboration with commercial game developers to create a humorous but clinically accurate game. They will also be conducting an evaluation to assess the effect of the game on prescribing behaviour.


Mr Castro Sanchez said: ‘We are confident that the app could have a dramatic impact on patient and user care. It has been suggested that 50 percent of antibiotics used in hospital are unnecessary, and that such use can lead to antibiotic resistance. Resistance is harmful not only for the patients affected, but also for the population at large. By making sure that doctors, pharmacists and nurses are using antibiotics better, we can improve patient care dramatically as well as preserving NHS resources.’

The game has been presented at a number of international infectious disease conferences, and is now intended to be adapted for use in teaching and learning in low and middle income settings.

The game is available to download here