How can national antimicrobial stewardship interventions in primary care be improved? A stakeholder consultation

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

doi:10.3390/antibiotics8040207

How can national antimicrobial stewardship interventions in primary care be improved? A stakeholder consultation

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

^*Corresponding author for this work

HCAI and AMR Divisional Office

Research output: Contribution to journal › Article › peer-review

16 Citations (Scopus)

Abstract

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.

Original language	English
Article number	207
Journal	Antibiotics
Volume	8
Issue number	4
DOIs	https://doi.org/10.3390/antibiotics8040207
Publication status	Published - Dec 2019

Bibliographical note

Funding Information:
Conflicts of Interest: C.B. reports receiving advisory board fees from Pfizer and Roche Molecular Systems, and grant support from Roche Molecular Diagnostics. Other authors declare no conflict of interest.

Funding Information:
This study was a part of a consultation commissioned and funded by Public Health England Behavioural Insights, and was carried out as a collaboration between the University of Oxford and Public Health England. S.T.-C. was supported by funding from the National Institute for Health Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with Public Health England [HPRU-2012-10041]. The views and opinions expressed in this paper are those of the authors and not necessarily those of the NHS, NIHR, the Department of Health and Social Care or Public Health England.

Funding Information:
Funding: This study was a part of a consultation commissioned and funded by Public Health England Behavioural Insights, and was carried out as a collaboration between the University of Oxford and Public Health England. S.T.-C. was supported by funding from the National Institute for Health Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with Public Health England [HPRU-2012-10041]. The views and opinions expressed in this paper are those of the authors and not necessarily those of the NHS, NIHR, the Department of Health and Social Care or Public Health England.

Publisher Copyright:
© 2019 by the authors. Licensee MDPI, Basel, Switzerland.

Keywords

Antibiotic prescribing
Antimicrobial stewardship
Behavior change
Implementation
Primary care
Stakeholder consultation

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3390/antibiotics8040207

Cite this

Borek, A. J., Wanat, M., Sallis, A., Ashiru Oredope, D., Atkins, L., Beech, E., Hopkins, S., Jones, L., McNulty, C., Shaw, K., Taborn, E., Butler, C., Chadborn, T., & Tonkin-Crine, S. (2019). How can national antimicrobial stewardship interventions in primary care be improved? A stakeholder consultation. Antibiotics, 8(4), Article 207. https://doi.org/10.3390/antibiotics8040207

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abstract = "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.",

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author = "Borek, {Aleksandra J.} and Marta Wanat and Anna Sallis and {Ashiru Oredope}, Diane and Lou Atkins and Elizabeth Beech and Susan Hopkins and Leah Jones and Cliodna McNulty and Karen Shaw and Esther Taborn and Christopher Butler and Tim Chadborn and Sarah Tonkin-Crine",

note = "Funding Information: Conflicts of Interest: C.B. reports receiving advisory board fees from Pfizer and Roche Molecular Systems, and grant support from Roche Molecular Diagnostics. Other authors declare no conflict of interest. Funding Information: This study was a part of a consultation commissioned and funded by Public Health England Behavioural Insights, and was carried out as a collaboration between the University of Oxford and Public Health England. S.T.-C. was supported by funding from the National Institute for Health Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with Public Health England [HPRU-2012-10041]. The views and opinions expressed in this paper are those of the authors and not necessarily those of the NHS, NIHR, the Department of Health and Social Care or Public Health England. Funding Information: Funding: This study was a part of a consultation commissioned and funded by Public Health England Behavioural Insights, and was carried out as a collaboration between the University of Oxford and Public Health England. S.T.-C. was supported by funding from the National Institute for Health Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with Public Health England [HPRU-2012-10041]. The views and opinions expressed in this paper are those of the authors and not necessarily those of the NHS, NIHR, the Department of Health and Social Care or Public Health England. Publisher Copyright: {\textcopyright} 2019 by the authors. Licensee MDPI, Basel, Switzerland.",

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AU - Atkins, Lou

AU - Beech, Elizabeth

AU - Hopkins, Susan

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AU - Taborn, Esther

AU - Butler, Christopher

AU - Chadborn, Tim

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N1 - Funding Information: Conflicts of Interest: C.B. reports receiving advisory board fees from Pfizer and Roche Molecular Systems, and grant support from Roche Molecular Diagnostics. Other authors declare no conflict of interest. Funding Information: This study was a part of a consultation commissioned and funded by Public Health England Behavioural Insights, and was carried out as a collaboration between the University of Oxford and Public Health England. S.T.-C. was supported by funding from the National Institute for Health Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with Public Health England [HPRU-2012-10041]. The views and opinions expressed in this paper are those of the authors and not necessarily those of the NHS, NIHR, the Department of Health and Social Care or Public Health England. Funding Information: Funding: This study was a part of a consultation commissioned and funded by Public Health England Behavioural Insights, and was carried out as a collaboration between the University of Oxford and Public Health England. S.T.-C. was supported by funding from the National Institute for Health Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with Public Health England [HPRU-2012-10041]. The views and opinions expressed in this paper are those of the authors and not necessarily those of the NHS, NIHR, the Department of Health and Social Care or Public Health England. Publisher Copyright: © 2019 by the authors. Licensee MDPI, Basel, Switzerland.

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How can national antimicrobial stewardship interventions in primary care be improved? A stakeholder consultation

Abstract

Bibliographical note

Keywords

UN SDGs

Access to Document

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