Improving antimicrobial use through antimicrobial stewardship in a lower-middle income setting: a mixed-methods study in a network of acute-care hospitals in Viet Nam
Objectives: This study aimed to analyse the current state of antimicrobial stewardship (AMS) in hospitals in Viet Nam, a lower-middle income country (LMIC), to identify factors determining success in AMS implementation and associated challenges to inform planning and design of future programmes. Met...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-12-01
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| Series: | Journal of Global Antimicrobial Resistance |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716521002150 |
| _version_ | 1798026723325902848 |
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| author | Vu Thi Lan Huong Ta Thi Dieu Ngan Huynh Phuong Thao Nguyen Thi Cam Tu Truong Anh Quan Behzad Nadjm Thomas Kesteman Nguyen Van Kinh H Rogier van Doorn |
| author_facet | Vu Thi Lan Huong Ta Thi Dieu Ngan Huynh Phuong Thao Nguyen Thi Cam Tu Truong Anh Quan Behzad Nadjm Thomas Kesteman Nguyen Van Kinh H Rogier van Doorn |
| author_sort | Vu Thi Lan Huong |
| collection | DOAJ |
| description | Objectives: This study aimed to analyse the current state of antimicrobial stewardship (AMS) in hospitals in Viet Nam, a lower-middle income country (LMIC), to identify factors determining success in AMS implementation and associated challenges to inform planning and design of future programmes. Methods: We conducted a mixed-methods study in seven acute-care hospitals in the antimicrobial resistance (AMR) surveillance network in Viet Nam. Data collection included 7 focus group discussions, 40 in-depth interviews and a self-administered quantitative survey of staff on AMR and AMS programmes. We summarised qualitative data by reporting the most common themes according to the core AMS elements, and analysed quantitative data using proportions and a linear mixed-effects model. Results: The findings reveal a complex picture of factors and actors involved in AMS implementation from the national level to the departmental and individual level within each hospital. The level of implementation varied, starting from the formation of an AMS committee, with or without active delivery of specific interventions. Development of treatment guidelines, pre-authorisation of antimicrobial drug classes, and post-prescription audit and feedback to doctors in selected clinical departments were the main interventions reported. A higher level of leadership support and commitment to AMS led to a higher level of engagement with AMS activities from the AMS team and effective collaboration between departments involved. Conclusion: Establishing country-specific guidelines on AMS staffing and adapting standards for AMS education and training from international resources are needed to support capacity building to implement AMS programmes effectively in LMICs such as Viet Nam. |
| first_indexed | 2024-04-11T18:39:57Z |
| format | Article |
| id | doaj.art-9c62d8e808c64886a53e041c743312c7 |
| institution | Directory Open Access Journal |
| issn | 2213-7165 |
| language | English |
| last_indexed | 2024-04-11T18:39:57Z |
| publishDate | 2021-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj.art-9c62d8e808c64886a53e041c743312c72022-12-22T04:09:02ZengElsevierJournal of Global Antimicrobial Resistance2213-71652021-12-0127212221Improving antimicrobial use through antimicrobial stewardship in a lower-middle income setting: a mixed-methods study in a network of acute-care hospitals in Viet NamVu Thi Lan Huong0Ta Thi Dieu Ngan1Huynh Phuong Thao2Nguyen Thi Cam Tu3Truong Anh Quan4Behzad Nadjm5Thomas Kesteman6Nguyen Van Kinh7H Rogier van Doorn8Oxford University Clinical Research Unit, 78 Giai Phong, Hanoi, Viet Nam; Corresponding author. Tel.: +84 24 3576 4320; fax: +84 24 3576 4319.National Hospital for Tropical Diseases, 78 Giai Phong, Hanoi, Viet NamHospital for Tropical Diseases, 764 Vo Van Kiet, Ho Chi Minh City, Viet NamOxford University Clinical Research Unit, 78 Giai Phong, Hanoi, Viet NamOxford University Clinical Research Unit, 78 Giai Phong, Hanoi, Viet NamOxford University Clinical Research Unit, 78 Giai Phong, Hanoi, Viet Nam; MRC Unit The Gambia at The London School of Hygiene & Tropical Medicine, Fajara, The GambiaOxford University Clinical Research Unit, 78 Giai Phong, Hanoi, Viet NamNational Hospital for Tropical Diseases, 78 Giai Phong, Hanoi, Viet NamOxford University Clinical Research Unit, 78 Giai Phong, Hanoi, Viet Nam; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UKObjectives: This study aimed to analyse the current state of antimicrobial stewardship (AMS) in hospitals in Viet Nam, a lower-middle income country (LMIC), to identify factors determining success in AMS implementation and associated challenges to inform planning and design of future programmes. Methods: We conducted a mixed-methods study in seven acute-care hospitals in the antimicrobial resistance (AMR) surveillance network in Viet Nam. Data collection included 7 focus group discussions, 40 in-depth interviews and a self-administered quantitative survey of staff on AMR and AMS programmes. We summarised qualitative data by reporting the most common themes according to the core AMS elements, and analysed quantitative data using proportions and a linear mixed-effects model. Results: The findings reveal a complex picture of factors and actors involved in AMS implementation from the national level to the departmental and individual level within each hospital. The level of implementation varied, starting from the formation of an AMS committee, with or without active delivery of specific interventions. Development of treatment guidelines, pre-authorisation of antimicrobial drug classes, and post-prescription audit and feedback to doctors in selected clinical departments were the main interventions reported. A higher level of leadership support and commitment to AMS led to a higher level of engagement with AMS activities from the AMS team and effective collaboration between departments involved. Conclusion: Establishing country-specific guidelines on AMS staffing and adapting standards for AMS education and training from international resources are needed to support capacity building to implement AMS programmes effectively in LMICs such as Viet Nam.http://www.sciencedirect.com/science/article/pii/S2213716521002150Antimicrobial stewardshipAntimicrobial prescribingAntimicrobial resistanceLow- and middle-income countriesViet Nam |
| spellingShingle | Vu Thi Lan Huong Ta Thi Dieu Ngan Huynh Phuong Thao Nguyen Thi Cam Tu Truong Anh Quan Behzad Nadjm Thomas Kesteman Nguyen Van Kinh H Rogier van Doorn Improving antimicrobial use through antimicrobial stewardship in a lower-middle income setting: a mixed-methods study in a network of acute-care hospitals in Viet Nam Journal of Global Antimicrobial Resistance Antimicrobial stewardship Antimicrobial prescribing Antimicrobial resistance Low- and middle-income countries Viet Nam |
| title | Improving antimicrobial use through antimicrobial stewardship in a lower-middle income setting: a mixed-methods study in a network of acute-care hospitals in Viet Nam |
| title_full | Improving antimicrobial use through antimicrobial stewardship in a lower-middle income setting: a mixed-methods study in a network of acute-care hospitals in Viet Nam |
| title_fullStr | Improving antimicrobial use through antimicrobial stewardship in a lower-middle income setting: a mixed-methods study in a network of acute-care hospitals in Viet Nam |
| title_full_unstemmed | Improving antimicrobial use through antimicrobial stewardship in a lower-middle income setting: a mixed-methods study in a network of acute-care hospitals in Viet Nam |
| title_short | Improving antimicrobial use through antimicrobial stewardship in a lower-middle income setting: a mixed-methods study in a network of acute-care hospitals in Viet Nam |
| title_sort | improving antimicrobial use through antimicrobial stewardship in a lower middle income setting a mixed methods study in a network of acute care hospitals in viet nam |
| topic | Antimicrobial stewardship Antimicrobial prescribing Antimicrobial resistance Low- and middle-income countries Viet Nam |
| url | http://www.sciencedirect.com/science/article/pii/S2213716521002150 |
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