TY - JOUR
T1 - Measuring appropriate antibiotic prescribing in acute hospitals
T2 - Development of a national audit tool through a Delphi consensus
AU - on behalf of Antibiotic Prescribing Appropriateness Measures (APAM) subgroup of the national Advisory Committee on Antimicrobial Resistance, Prescribing and Healthcare Associated Infection (ARPHAI)
AU - Hood, Graeme
AU - Hand, Kieran S.
AU - Cramp, Emma
AU - Howard, Philip
AU - Hopkins, Susan
AU - Ashiru Oredope, Diane
N1 - Funding Information:
This research received no external funding and was conducted by Public Health England
Publisher Copyright:
© 2019 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2019/6
Y1 - 2019/6
N2 - This study developed a patient-level audit tool to assess the appropriateness of antibiotic prescribing in acute National Health Service (NHS) hospitals in the UK. A modified Delphi process was used to evaluate variables identified from published literature that could be used to support an assessment of appropriateness of antibiotic use. At a national workshop, 22 infection experts reached a consensus to define appropriate prescribing and agree upon an initial draft audit tool. Following this, a national multidisciplinary panel of 19 infection experts, of whom only one was part of the workshop, was convened to evaluate and validate variables using questionnaires to confirm the relevance of each variable in assessing appropriate prescribing. The initial evidence synthesis of published literature identified 25 variables that could be used to support an assessment of appropriateness of antibiotic use. All the panel members reviewed the variables for the first round of the Delphi; the panel accepted 23 out of 25 variables. Following review by the project team, one of the two rejected variables was rephrased, and the second neutral variable was re-scored. The panel accepted both these variables in round two with a 68% response rate. Accepted variables were used to develop an audit tool to determine the extent of appropriateness of antibiotic prescribing at the individual patient level in acute NHS hospitals through infection expert consensus based on the results of a Delphi process.
AB - This study developed a patient-level audit tool to assess the appropriateness of antibiotic prescribing in acute National Health Service (NHS) hospitals in the UK. A modified Delphi process was used to evaluate variables identified from published literature that could be used to support an assessment of appropriateness of antibiotic use. At a national workshop, 22 infection experts reached a consensus to define appropriate prescribing and agree upon an initial draft audit tool. Following this, a national multidisciplinary panel of 19 infection experts, of whom only one was part of the workshop, was convened to evaluate and validate variables using questionnaires to confirm the relevance of each variable in assessing appropriate prescribing. The initial evidence synthesis of published literature identified 25 variables that could be used to support an assessment of appropriateness of antibiotic use. All the panel members reviewed the variables for the first round of the Delphi; the panel accepted 23 out of 25 variables. Following review by the project team, one of the two rejected variables was rephrased, and the second neutral variable was re-scored. The panel accepted both these variables in round two with a 68% response rate. Accepted variables were used to develop an audit tool to determine the extent of appropriateness of antibiotic prescribing at the individual patient level in acute NHS hospitals through infection expert consensus based on the results of a Delphi process.
KW - Antibiotics
KW - Antimicrobial resistance
KW - Antimicrobial stewardship
KW - Days of therapy
KW - Inappropriate prescribing
KW - Start Smart then Focus
UR - http://www.scopus.com/inward/record.url?scp=85067041083&partnerID=8YFLogxK
U2 - 10.3390/antibiotics8020049
DO - 10.3390/antibiotics8020049
M3 - Article
AN - SCOPUS:85067041083
VL - 8
JO - Antibiotics
JF - Antibiotics
SN - 2079-6382
IS - 2
M1 - 49
ER -