How Can National Antimicrobial Stewardship Interventions in Primary Care Be Improved? A Stakeholder Consultation
Many antimicrobial stewardship (AMS) interventions have been implemented in England, facilitating decreases in antibiotic prescribing. Nevertheless, there is substantial variation in antibiotic prescribing across England and some healthcare organizations remain high prescribers of antibiotics. This...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2019-10-01
|
| Series: | Antibiotics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-6382/8/4/207 |
| _version_ | 1819108350136156160 |
|---|---|
| author | Aleksandra J. Borek Marta Wanat Anna Sallis Diane Ashiru-Oredope Lou Atkins Elizabeth Beech Susan Hopkins Leah Jones Cliodna McNulty Karen Shaw Esther Taborn Christopher Butler Tim Chadborn Sarah Tonkin-Crine |
| author_facet | Aleksandra J. Borek Marta Wanat Anna Sallis Diane Ashiru-Oredope Lou Atkins Elizabeth Beech Susan Hopkins Leah Jones Cliodna McNulty Karen Shaw Esther Taborn Christopher Butler Tim Chadborn Sarah Tonkin-Crine |
| author_sort | Aleksandra J. Borek |
| collection | DOAJ |
| description | Many antimicrobial stewardship (AMS) interventions have been implemented in England, facilitating decreases in antibiotic prescribing. Nevertheless, there is substantial variation in antibiotic prescribing across England and some healthcare organizations remain high prescribers of antibiotics. This study aimed to identify ways to improve AMS interventions to further optimize antibiotic prescribing in primary care in England. Stakeholders representing different primary care settings were invited to, and 15 participated in, a focus group or telephone interview to identify ways to improve existing AMS interventions. Forty-five intervention suggestions were generated and 31 were prioritized for inclusion in an online survey. Fifteen stakeholders completed the survey appraising each proposed intervention using the pre-defined APEASE (i.e., Affordability, Practicability, Effectiveness, Acceptability, Safety, and Equity) criteria. The highest-rated nine interventions were prioritized as most promising and feasible, including: quality improvement, multidisciplinary peer learning, appointing AMS leads, auditing individual-level prescribing, developing tools for prescribing audits, improving inductions for new prescribers, ensuring consistent local approaches to antibiotic prescribing, providing online AMS training to all patient-facing staff, and increasing staff time available for AMS work with standardizing AMS-related roles. These prioritized interventions could be incorporated into existing national interventions or developed as stand-alone interventions to help further optimize antibiotic prescribing in primary care in England. |
| first_indexed | 2024-12-22T03:08:32Z |
| format | Article |
| id | doaj.art-68579d3efa9a4bdcadf8d3e13a3f1c07 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-12-22T03:08:32Z |
| publishDate | 2019-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-68579d3efa9a4bdcadf8d3e13a3f1c072022-12-21T18:40:59ZengMDPI AGAntibiotics2079-63822019-10-018420710.3390/antibiotics8040207antibiotics8040207How Can National Antimicrobial Stewardship Interventions in Primary Care Be Improved? A Stakeholder ConsultationAleksandra J. Borek0Marta Wanat1Anna Sallis2Diane Ashiru-Oredope3Lou Atkins4Elizabeth Beech5Susan Hopkins6Leah Jones7Cliodna McNulty8Karen Shaw9Esther Taborn10Christopher Butler11Tim Chadborn12Sarah Tonkin-Crine13Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford OX2 6GG, UKNuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford OX2 6GG, UKPublic Health England Behavioural Insights, London SE1 8UG, UKPublic Health England, London SE1 8UG, UKCentre for Behaviour Change, University College London, London WC1E 6BT, UKNHS England and NHS Improvement, London SE1 6LH, UKPublic Health England, London SE1 8UG, UKPublic Health England, London SE1 8UG, UKPublic Health England, London SE1 8UG, UKPublic Health England, London SE1 8UG, UKNHS England and NHS Improvement, London SE1 6LH, UKNuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford OX2 6GG, UKPublic Health England Behavioural Insights, London SE1 8UG, UKNuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford OX2 6GG, UKMany antimicrobial stewardship (AMS) interventions have been implemented in England, facilitating decreases in antibiotic prescribing. Nevertheless, there is substantial variation in antibiotic prescribing across England and some healthcare organizations remain high prescribers of antibiotics. This study aimed to identify ways to improve AMS interventions to further optimize antibiotic prescribing in primary care in England. Stakeholders representing different primary care settings were invited to, and 15 participated in, a focus group or telephone interview to identify ways to improve existing AMS interventions. Forty-five intervention suggestions were generated and 31 were prioritized for inclusion in an online survey. Fifteen stakeholders completed the survey appraising each proposed intervention using the pre-defined APEASE (i.e., Affordability, Practicability, Effectiveness, Acceptability, Safety, and Equity) criteria. The highest-rated nine interventions were prioritized as most promising and feasible, including: quality improvement, multidisciplinary peer learning, appointing AMS leads, auditing individual-level prescribing, developing tools for prescribing audits, improving inductions for new prescribers, ensuring consistent local approaches to antibiotic prescribing, providing online AMS training to all patient-facing staff, and increasing staff time available for AMS work with standardizing AMS-related roles. These prioritized interventions could be incorporated into existing national interventions or developed as stand-alone interventions to help further optimize antibiotic prescribing in primary care in England.https://www.mdpi.com/2079-6382/8/4/207antimicrobial stewardshipantibiotic prescribingprimary careimplementationbehavior changestakeholder consultation |
| spellingShingle | Aleksandra J. Borek Marta Wanat Anna Sallis Diane Ashiru-Oredope Lou Atkins Elizabeth Beech Susan Hopkins Leah Jones Cliodna McNulty Karen Shaw Esther Taborn Christopher Butler Tim Chadborn Sarah Tonkin-Crine How Can National Antimicrobial Stewardship Interventions in Primary Care Be Improved? A Stakeholder Consultation Antibiotics antimicrobial stewardship antibiotic prescribing primary care implementation behavior change stakeholder consultation |
| title | How Can National Antimicrobial Stewardship Interventions in Primary Care Be Improved? A Stakeholder Consultation |
| title_full | How Can National Antimicrobial Stewardship Interventions in Primary Care Be Improved? A Stakeholder Consultation |
| title_fullStr | How Can National Antimicrobial Stewardship Interventions in Primary Care Be Improved? A Stakeholder Consultation |
| title_full_unstemmed | How Can National Antimicrobial Stewardship Interventions in Primary Care Be Improved? A Stakeholder Consultation |
| title_short | How Can National Antimicrobial Stewardship Interventions in Primary Care Be Improved? A Stakeholder Consultation |
| title_sort | how can national antimicrobial stewardship interventions in primary care be improved a stakeholder consultation |
| topic | antimicrobial stewardship antibiotic prescribing primary care implementation behavior change stakeholder consultation |
| url | https://www.mdpi.com/2079-6382/8/4/207 |
| work_keys_str_mv | AT aleksandrajborek howcannationalantimicrobialstewardshipinterventionsinprimarycarebeimprovedastakeholderconsultation AT martawanat howcannationalantimicrobialstewardshipinterventionsinprimarycarebeimprovedastakeholderconsultation AT annasallis howcannationalantimicrobialstewardshipinterventionsinprimarycarebeimprovedastakeholderconsultation AT dianeashiruoredope howcannationalantimicrobialstewardshipinterventionsinprimarycarebeimprovedastakeholderconsultation AT louatkins howcannationalantimicrobialstewardshipinterventionsinprimarycarebeimprovedastakeholderconsultation AT elizabethbeech howcannationalantimicrobialstewardshipinterventionsinprimarycarebeimprovedastakeholderconsultation AT susanhopkins howcannationalantimicrobialstewardshipinterventionsinprimarycarebeimprovedastakeholderconsultation AT leahjones howcannationalantimicrobialstewardshipinterventionsinprimarycarebeimprovedastakeholderconsultation AT cliodnamcnulty howcannationalantimicrobialstewardshipinterventionsinprimarycarebeimprovedastakeholderconsultation AT karenshaw howcannationalantimicrobialstewardshipinterventionsinprimarycarebeimprovedastakeholderconsultation AT esthertaborn howcannationalantimicrobialstewardshipinterventionsinprimarycarebeimprovedastakeholderconsultation AT christopherbutler howcannationalantimicrobialstewardshipinterventionsinprimarycarebeimprovedastakeholderconsultation AT timchadborn howcannationalantimicrobialstewardshipinterventionsinprimarycarebeimprovedastakeholderconsultation AT sarahtonkincrine howcannationalantimicrobialstewardshipinterventionsinprimarycarebeimprovedastakeholderconsultation |