A Multifaceted Intervention and Its Effects on Antibiotic Usage in Norwegian Nursing Homes
We explored the impact of an antibiotic quality improvement intervention across 33 nursing homes (NHs) in one Norwegian county, compared against four control counties. This 12-month multifaceted intervention consisted of three physical conferences, including educational sessions, workshops, antibiot...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-08-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/12/9/1372 |
| _version_ | 1797581575717650432 |
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| author | Nicolay Jonassen Harbin Jon Birger Haug Morten Lindbæk Per Espen Akselsen Maria Romøren |
| author_facet | Nicolay Jonassen Harbin Jon Birger Haug Morten Lindbæk Per Espen Akselsen Maria Romøren |
| author_sort | Nicolay Jonassen Harbin |
| collection | DOAJ |
| description | We explored the impact of an antibiotic quality improvement intervention across 33 nursing homes (NHs) in one Norwegian county, compared against four control counties. This 12-month multifaceted intervention consisted of three physical conferences, including educational sessions, workshops, antibiotic feedback reports, and academic detailing sessions. We provided clinical guiding checklists to participating NHs. Pharmacy sales data served as a measure of systemic antibiotic use. The primary outcome was a change in antibiotic use in DDD/100 BD from the baseline through the intervention, assessed using linear mixed models to identify changes in antibiotic use. Total antibiotic use decreased by 15.8%, from 8.68 to 7.31 DDD/100BD (model-based estimated change (MBEC): −1.37, 95% CI: −2.35 to −0.41) in the intervention group, albeit not a significantly greater reduction than in the control counties (model-based estimated difference in change (MBEDC): −0.75, 95% CI: −1.91 to 0.41). Oral antibiotic usage for urinary tract infections (UTI-AB) decreased 32.8%, from 4.08 to 2.74 DDD/100BD (MBEC: −1.34, 95% CI: −1.85 to −0.84), a significantly greater reduction than in the control counties (MBEDC: −0.9, 95% CI: −1.28 to −0.31). The multifaceted intervention may reduce UTI-AB use in NHs, whereas adjustments in the implementation strategy may be needed to reduce total antibiotic use. |
| first_indexed | 2024-03-10T23:06:59Z |
| format | Article |
| id | doaj.art-f5f185db2c944118aac99be90f21f94c |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T23:06:59Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-f5f185db2c944118aac99be90f21f94c2023-11-19T09:16:51ZengMDPI AGAntibiotics2079-63822023-08-01129137210.3390/antibiotics12091372A Multifaceted Intervention and Its Effects on Antibiotic Usage in Norwegian Nursing HomesNicolay Jonassen Harbin0Jon Birger Haug1Morten Lindbæk2Per Espen Akselsen3Maria Romøren4Antibiotic Center for Primary Care, Department of General Practice, Institute of Health and Society, University of Oslo, 0450 Oslo, NorwayDepartment of Infection Control, Østfold Health Trust, Kalnes, 1714 Grålum, NorwayAntibiotic Center for Primary Care, Department of General Practice, Institute of Health and Society, University of Oslo, 0450 Oslo, NorwayNorwegian Centre for Antibiotic Use in Hospitals, Department of Research and Development, Haukeland University Hospital, 5021 Bergen, NorwayDepartment of General Practice Institute of Health and Society, Faculty of Medicine, University of Oslo, 0450 Oslo, NorwayWe explored the impact of an antibiotic quality improvement intervention across 33 nursing homes (NHs) in one Norwegian county, compared against four control counties. This 12-month multifaceted intervention consisted of three physical conferences, including educational sessions, workshops, antibiotic feedback reports, and academic detailing sessions. We provided clinical guiding checklists to participating NHs. Pharmacy sales data served as a measure of systemic antibiotic use. The primary outcome was a change in antibiotic use in DDD/100 BD from the baseline through the intervention, assessed using linear mixed models to identify changes in antibiotic use. Total antibiotic use decreased by 15.8%, from 8.68 to 7.31 DDD/100BD (model-based estimated change (MBEC): −1.37, 95% CI: −2.35 to −0.41) in the intervention group, albeit not a significantly greater reduction than in the control counties (model-based estimated difference in change (MBEDC): −0.75, 95% CI: −1.91 to 0.41). Oral antibiotic usage for urinary tract infections (UTI-AB) decreased 32.8%, from 4.08 to 2.74 DDD/100BD (MBEC: −1.34, 95% CI: −1.85 to −0.84), a significantly greater reduction than in the control counties (MBEDC: −0.9, 95% CI: −1.28 to −0.31). The multifaceted intervention may reduce UTI-AB use in NHs, whereas adjustments in the implementation strategy may be needed to reduce total antibiotic use.https://www.mdpi.com/2079-6382/12/9/1372antibiotic stewardshipacademic detailingquality improvementnursing homesurinary tract infection |
| spellingShingle | Nicolay Jonassen Harbin Jon Birger Haug Morten Lindbæk Per Espen Akselsen Maria Romøren A Multifaceted Intervention and Its Effects on Antibiotic Usage in Norwegian Nursing Homes Antibiotics antibiotic stewardship academic detailing quality improvement nursing homes urinary tract infection |
| title | A Multifaceted Intervention and Its Effects on Antibiotic Usage in Norwegian Nursing Homes |
| title_full | A Multifaceted Intervention and Its Effects on Antibiotic Usage in Norwegian Nursing Homes |
| title_fullStr | A Multifaceted Intervention and Its Effects on Antibiotic Usage in Norwegian Nursing Homes |
| title_full_unstemmed | A Multifaceted Intervention and Its Effects on Antibiotic Usage in Norwegian Nursing Homes |
| title_short | A Multifaceted Intervention and Its Effects on Antibiotic Usage in Norwegian Nursing Homes |
| title_sort | multifaceted intervention and its effects on antibiotic usage in norwegian nursing homes |
| topic | antibiotic stewardship academic detailing quality improvement nursing homes urinary tract infection |
| url | https://www.mdpi.com/2079-6382/12/9/1372 |
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