Barriers and enablers to blood culture sampling in Indonesia, Thailand and Viet Nam: a Theoretical Domains Framework-based survey

<p><strong>Objective</strong> Blood culture (BC) sampling is recommended for all suspected sepsis patients prior to antibiotic administration. We examine barriers and enablers to BC sampling in three Southeast Asian countries.</p> <p><strong>Design</strong>...

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Main Authors: Suntornsut, P, Asadinia, KS, Limato, R, Tamara, A, Rotty, LWA, Bramanti, R, Nusantara, DU, Nelwan, EJ, Khusuwan, S, Suphamongkholchaikul, W, Chamnan, P, Piyaphanee, W, Vu, HTL, Nguyen, YH, Nguyen, KH, Pham, TN, Le, QM, Vu, VH, Chau, DM, Vo, DETH, Harriss, EK, van Doorn, HR, Hamers, RL, Lorencatto, F, Atkins, L, Limmathurotsakul, D
Format: Journal article
Language:English
Published: BMJ Publishing Group 2024
_version_ 1797113294255816704
author Suntornsut, P
Asadinia, KS
Limato, R
Tamara, A
Rotty, LWA
Bramanti, R
Nusantara, DU
Nelwan, EJ
Khusuwan, S
Suphamongkholchaikul, W
Chamnan, P
Piyaphanee, W
Vu, HTL
Nguyen, YH
Nguyen, KH
Pham, TN
Le, QM
Vu, VH
Chau, DM
Vo, DETH
Harriss, EK
van Doorn, HR
Hamers, RL
Lorencatto, F
Atkins, L
Limmathurotsakul, D
author_facet Suntornsut, P
Asadinia, KS
Limato, R
Tamara, A
Rotty, LWA
Bramanti, R
Nusantara, DU
Nelwan, EJ
Khusuwan, S
Suphamongkholchaikul, W
Chamnan, P
Piyaphanee, W
Vu, HTL
Nguyen, YH
Nguyen, KH
Pham, TN
Le, QM
Vu, VH
Chau, DM
Vo, DETH
Harriss, EK
van Doorn, HR
Hamers, RL
Lorencatto, F
Atkins, L
Limmathurotsakul, D
author_sort Suntornsut, P
collection OXFORD
description <p><strong>Objective</strong> Blood culture (BC) sampling is recommended for all suspected sepsis patients prior to antibiotic administration. We examine barriers and enablers to BC sampling in three Southeast Asian countries.</p> <p><strong>Design</strong> A Theoretical Domains Framework (TDF)-based survey, comprising a case scenario of a patient presenting with community-acquired sepsis and all 14 TDF domains of barriers/enablers to BC sampling.</p> <p><strong>Setting</strong> Hospitals in Indonesia, Thailand and Viet Nam, December 2021 to 30 April 2022.</p> <p><strong>Participants</strong> 1070 medical doctors and 238 final-year medical students were participated in this study. Half of the respondents were women (n=680, 52%) and most worked in governmental hospitals (n=980, 75.4%).</p> <p><strong>Outcome measures</strong> Barriers and enablers to BC sampling.</p> <p><strong>Results</strong> The proportion of respondents who answered that they would definitely take BC in the case scenario was highest at 89.8% (273/304) in Thailand, followed by 50.5% (252/499) in Viet Nam and 31.3% (157/501) in Indonesia (p<0.001). Barriers/enablers in nine TDF domains were considered key in influencing BC sampling, including ‘priority of BC (TDF-goals)’, ‘perception about their role to order or initiate an order for BC (TDF-social professional role and identity)’, ‘perception that BC is helpful (TDF-beliefs about consequences)’, ‘intention to follow guidelines (TDF-intention)’, ‘awareness of guidelines (TDF-knowledge)’, ‘norms of BC sampling (TDF-social influence)’, ‘consequences that discourage BC sampling (TDF-reinforcement)’, ‘perceived cost-effectiveness of BC (TDF-environmental context and resources)’ and ‘regulation on cost reimbursement (TDF-behavioural regulation)’. There was substantial heterogeneity between the countries. In most domains, the lower (higher) proportion of Thai respondents experienced the barriers (enablers) compared with that of Indonesian and Vietnamese respondents. A range of suggested intervention types and policy options was identified.</p> <p><strong>Conclusions</strong> Barriers and enablers to BC sampling are varied and heterogenous. Cost-related barriers are more common in more resource-limited countries, while many barriers are not directly related to cost. Context-specific multifaceted interventions at both hospital and policy levels are required to improve diagnostic stewardship practices.</p>
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spelling oxford-uuid:e5110971-103b-4599-a46c-01f67f7a62de2024-04-16T16:22:04ZBarriers and enablers to blood culture sampling in Indonesia, Thailand and Viet Nam: a Theoretical Domains Framework-based surveyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:e5110971-103b-4599-a46c-01f67f7a62deEnglishSymplectic ElementsBMJ Publishing Group2024Suntornsut, PAsadinia, KSLimato, RTamara, ARotty, LWABramanti, RNusantara, DUNelwan, EJKhusuwan, SSuphamongkholchaikul, WChamnan, PPiyaphanee, WVu, HTLNguyen, YHNguyen, KHPham, TNLe, QMVu, VHChau, DMVo, DETHHarriss, EKvan Doorn, HRHamers, RLLorencatto, FAtkins, LLimmathurotsakul, D<p><strong>Objective</strong> Blood culture (BC) sampling is recommended for all suspected sepsis patients prior to antibiotic administration. We examine barriers and enablers to BC sampling in three Southeast Asian countries.</p> <p><strong>Design</strong> A Theoretical Domains Framework (TDF)-based survey, comprising a case scenario of a patient presenting with community-acquired sepsis and all 14 TDF domains of barriers/enablers to BC sampling.</p> <p><strong>Setting</strong> Hospitals in Indonesia, Thailand and Viet Nam, December 2021 to 30 April 2022.</p> <p><strong>Participants</strong> 1070 medical doctors and 238 final-year medical students were participated in this study. Half of the respondents were women (n=680, 52%) and most worked in governmental hospitals (n=980, 75.4%).</p> <p><strong>Outcome measures</strong> Barriers and enablers to BC sampling.</p> <p><strong>Results</strong> The proportion of respondents who answered that they would definitely take BC in the case scenario was highest at 89.8% (273/304) in Thailand, followed by 50.5% (252/499) in Viet Nam and 31.3% (157/501) in Indonesia (p<0.001). Barriers/enablers in nine TDF domains were considered key in influencing BC sampling, including ‘priority of BC (TDF-goals)’, ‘perception about their role to order or initiate an order for BC (TDF-social professional role and identity)’, ‘perception that BC is helpful (TDF-beliefs about consequences)’, ‘intention to follow guidelines (TDF-intention)’, ‘awareness of guidelines (TDF-knowledge)’, ‘norms of BC sampling (TDF-social influence)’, ‘consequences that discourage BC sampling (TDF-reinforcement)’, ‘perceived cost-effectiveness of BC (TDF-environmental context and resources)’ and ‘regulation on cost reimbursement (TDF-behavioural regulation)’. There was substantial heterogeneity between the countries. In most domains, the lower (higher) proportion of Thai respondents experienced the barriers (enablers) compared with that of Indonesian and Vietnamese respondents. A range of suggested intervention types and policy options was identified.</p> <p><strong>Conclusions</strong> Barriers and enablers to BC sampling are varied and heterogenous. Cost-related barriers are more common in more resource-limited countries, while many barriers are not directly related to cost. Context-specific multifaceted interventions at both hospital and policy levels are required to improve diagnostic stewardship practices.</p>
spellingShingle Suntornsut, P
Asadinia, KS
Limato, R
Tamara, A
Rotty, LWA
Bramanti, R
Nusantara, DU
Nelwan, EJ
Khusuwan, S
Suphamongkholchaikul, W
Chamnan, P
Piyaphanee, W
Vu, HTL
Nguyen, YH
Nguyen, KH
Pham, TN
Le, QM
Vu, VH
Chau, DM
Vo, DETH
Harriss, EK
van Doorn, HR
Hamers, RL
Lorencatto, F
Atkins, L
Limmathurotsakul, D
Barriers and enablers to blood culture sampling in Indonesia, Thailand and Viet Nam: a Theoretical Domains Framework-based survey
title Barriers and enablers to blood culture sampling in Indonesia, Thailand and Viet Nam: a Theoretical Domains Framework-based survey
title_full Barriers and enablers to blood culture sampling in Indonesia, Thailand and Viet Nam: a Theoretical Domains Framework-based survey
title_fullStr Barriers and enablers to blood culture sampling in Indonesia, Thailand and Viet Nam: a Theoretical Domains Framework-based survey
title_full_unstemmed Barriers and enablers to blood culture sampling in Indonesia, Thailand and Viet Nam: a Theoretical Domains Framework-based survey
title_short Barriers and enablers to blood culture sampling in Indonesia, Thailand and Viet Nam: a Theoretical Domains Framework-based survey
title_sort barriers and enablers to blood culture sampling in indonesia thailand and viet nam a theoretical domains framework based survey
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