Implementation of a Delayed Prescribing Model to Reduce Antibiotic Prescribing for Suspected Upper Respiratory Tract Infections in a Hospital Outpatient Department, Ghana
<i>Background</i>: High levels of antimicrobial resistance (AMR) in Ghana require the exploration of new approaches to optimise antimicrobial prescribing. This study aims to establish the feasibility of implementation of different delayed/back-up prescribing models on antimicrobial presc...
| Principais autores: | , , , , , , , , , |
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| Formato: | Artigo |
| Idioma: | English |
| Publicado em: |
MDPI AG
2020-11-01
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| coleção: | Antibiotics |
| Assuntos: | |
| Acesso em linha: | https://www.mdpi.com/2079-6382/9/11/773 |
| _version_ | 1827702924540641280 |
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| author | Sam Ghebrehewet Wendi Shepherd Edwin Panford-Quainoo Saran Shantikumar Valerie Decraene Rajesh Rajendran Menaal Kaushal Afua Akuffo Dinah Ayerh George Amofah |
| author_facet | Sam Ghebrehewet Wendi Shepherd Edwin Panford-Quainoo Saran Shantikumar Valerie Decraene Rajesh Rajendran Menaal Kaushal Afua Akuffo Dinah Ayerh George Amofah |
| author_sort | Sam Ghebrehewet |
| collection | DOAJ |
| description | <i>Background</i>: High levels of antimicrobial resistance (AMR) in Ghana require the exploration of new approaches to optimise antimicrobial prescribing. This study aims to establish the feasibility of implementation of different delayed/back-up prescribing models on antimicrobial prescribing for upper respiratory tract infections (URTIs). <i>Methods</i>: This study was part of a quality improvement project at LEKMA Hospital, Ghana, (Dec 2019–Feb 2020). Patients meeting inclusion criteria were assigned to one of four groups (Group 0: No prescription given; Group 1; Patient received post-dated antibiotic prescription; Group 2: Offer of a rapid reassessment of patient by a nurse practitioner after 3 days; and Group 3: Post-dated prescription forwarded to hospital pharmacy). Patients were contacted 10 days afterwards to ascertain wellbeing and actions taken, and patients were asked rate the service on a Likert scale. Post-study informal discussions were conducted with hospital staff. <i>Results:</i> In total, 142 patients met inclusion criteria. Groups 0, 1, 2 and 3 had 61, 16, 44 and 21 patients, respectively. Common diagnosis was sore throat (73%). Only one patient took antibiotics after 3 days. Nearly all (141/142) patients were successfully contacted on day 10, and of these, 102 (72%) rated their experiences as good or very good. Informal discussions with staff revealed improved knowledge of AMR. <i>Conclusions:</i> Delayed/back-up prescribing can reduce antibiotic consumption amongst outpatient department patients with suspected URTIs. Delayed/back-up prescribing can be implemented safely in low and middle-income countries (LMICs). |
| first_indexed | 2024-03-10T15:06:25Z |
| format | Article |
| id | doaj.art-b910f667d1774ee6a4abe5302ff3d054 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T15:06:25Z |
| publishDate | 2020-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-b910f667d1774ee6a4abe5302ff3d0542023-11-20T19:42:50ZengMDPI AGAntibiotics2079-63822020-11-0191177310.3390/antibiotics9110773Implementation of a Delayed Prescribing Model to Reduce Antibiotic Prescribing for Suspected Upper Respiratory Tract Infections in a Hospital Outpatient Department, GhanaSam Ghebrehewet0Wendi Shepherd1Edwin Panford-Quainoo2Saran Shantikumar3Valerie Decraene4Rajesh Rajendran5Menaal Kaushal6Afua Akuffo7Dinah Ayerh8George Amofah9Public Health England North West Health Protection Team, Liverpool L3 1JR, UKPublic Health England North West Health Protection Team, Liverpool L3 1JR, UKLiverpool School of Tropical Medicine, Liverpool L3 5QA, UKWarwick Medical School, University of Warwick, Coventry CV4 7HL, UKPublic Health England National Infection Service, Liverpool L3 1JR, UKMid Cheshire NHS Foundation Trust, Crewe CW1 4QJ, UKLEKMA Hospital, Accra, GhanaLEKMA Hospital, Accra, GhanaLEKMA Hospital, Accra, GhanaLEKMA Hospital, Accra, Ghana<i>Background</i>: High levels of antimicrobial resistance (AMR) in Ghana require the exploration of new approaches to optimise antimicrobial prescribing. This study aims to establish the feasibility of implementation of different delayed/back-up prescribing models on antimicrobial prescribing for upper respiratory tract infections (URTIs). <i>Methods</i>: This study was part of a quality improvement project at LEKMA Hospital, Ghana, (Dec 2019–Feb 2020). Patients meeting inclusion criteria were assigned to one of four groups (Group 0: No prescription given; Group 1; Patient received post-dated antibiotic prescription; Group 2: Offer of a rapid reassessment of patient by a nurse practitioner after 3 days; and Group 3: Post-dated prescription forwarded to hospital pharmacy). Patients were contacted 10 days afterwards to ascertain wellbeing and actions taken, and patients were asked rate the service on a Likert scale. Post-study informal discussions were conducted with hospital staff. <i>Results:</i> In total, 142 patients met inclusion criteria. Groups 0, 1, 2 and 3 had 61, 16, 44 and 21 patients, respectively. Common diagnosis was sore throat (73%). Only one patient took antibiotics after 3 days. Nearly all (141/142) patients were successfully contacted on day 10, and of these, 102 (72%) rated their experiences as good or very good. Informal discussions with staff revealed improved knowledge of AMR. <i>Conclusions:</i> Delayed/back-up prescribing can reduce antibiotic consumption amongst outpatient department patients with suspected URTIs. Delayed/back-up prescribing can be implemented safely in low and middle-income countries (LMICs).https://www.mdpi.com/2079-6382/9/11/773antimicrobial resistance (AMR)antimicrobial stewardship (AMS)delayed/back-up prescribingupper respiratory tract infectionsdeveloping countriesLMICs |
| spellingShingle | Sam Ghebrehewet Wendi Shepherd Edwin Panford-Quainoo Saran Shantikumar Valerie Decraene Rajesh Rajendran Menaal Kaushal Afua Akuffo Dinah Ayerh George Amofah Implementation of a Delayed Prescribing Model to Reduce Antibiotic Prescribing for Suspected Upper Respiratory Tract Infections in a Hospital Outpatient Department, Ghana Antibiotics antimicrobial resistance (AMR) antimicrobial stewardship (AMS) delayed/back-up prescribing upper respiratory tract infections developing countries LMICs |
| title | Implementation of a Delayed Prescribing Model to Reduce Antibiotic Prescribing for Suspected Upper Respiratory Tract Infections in a Hospital Outpatient Department, Ghana |
| title_full | Implementation of a Delayed Prescribing Model to Reduce Antibiotic Prescribing for Suspected Upper Respiratory Tract Infections in a Hospital Outpatient Department, Ghana |
| title_fullStr | Implementation of a Delayed Prescribing Model to Reduce Antibiotic Prescribing for Suspected Upper Respiratory Tract Infections in a Hospital Outpatient Department, Ghana |
| title_full_unstemmed | Implementation of a Delayed Prescribing Model to Reduce Antibiotic Prescribing for Suspected Upper Respiratory Tract Infections in a Hospital Outpatient Department, Ghana |
| title_short | Implementation of a Delayed Prescribing Model to Reduce Antibiotic Prescribing for Suspected Upper Respiratory Tract Infections in a Hospital Outpatient Department, Ghana |
| title_sort | implementation of a delayed prescribing model to reduce antibiotic prescribing for suspected upper respiratory tract infections in a hospital outpatient department ghana |
| topic | antimicrobial resistance (AMR) antimicrobial stewardship (AMS) delayed/back-up prescribing upper respiratory tract infections developing countries LMICs |
| url | https://www.mdpi.com/2079-6382/9/11/773 |
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