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Implementation of a delayed prescribing model to reduce antibiotic prescribing for suspected upper respiratory tract infections in a hospital outpatient department, Ghana
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Ghebrehewet, Sam, Shepherd, Wendi, Panford-Quainoo, Edwin, Shantikumar, Saran, Decraene, Valerie, Rajendran, Rajesh, Kaushal, Menaal, Akuffo, Afua, Ayerh, Dinah and Amofah, George (2020) Implementation of a delayed prescribing model to reduce antibiotic prescribing for suspected upper respiratory tract infections in a hospital outpatient department, Ghana. Antibiotics, 9 (11). 773. doi:10.3390/antibiotics9110773 ISSN 2079-6382.
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WRAP-implementation-delayed-prescribing-model-reduce-antibiotic-prescribing-suspected-upper-respiratory-tract-infection-Shantikumar-2020.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (545Kb) | Preview |
Official URL: https://doi.org/10.3390/antibiotics9110773
Abstract
Background: 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).
Methods: 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. Results: 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.
Conclusions: 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).
| Item Type: | Journal Article | ||||||
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| Subjects: | Q Science > QR Microbiology R Medicine > RC Internal medicine R Medicine > RM Therapeutics. Pharmacology |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Drugs -- Prescribing -- Ghana, Respiratory infections -- Treatment -- Ghana, Drug resistance in microorganisms -- Ghana, Antibiotics | ||||||
| Journal or Publication Title: | Antibiotics | ||||||
| Publisher: | M.D.P.I.AG | ||||||
| ISSN: | 2079-6382 | ||||||
| Official Date: | 4 November 2020 | ||||||
| Dates: |
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| Volume: | 9 | ||||||
| Number: | 11 | ||||||
| Article Number: | 773 | ||||||
| DOI: | 10.3390/antibiotics9110773 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||
| Date of first compliant deposit: | 6 November 2020 | ||||||
| Date of first compliant Open Access: | 9 November 2020 | ||||||
| RIOXX Funder/Project Grant: |
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