The Library
Implementing antibiotic stewardship in high-prescribing English general practices : a mixed-methods study
Tools
Tonkin-Crine, Sarah, McLeod, Monsey, Borek, Aleksandra J, Campbell, Anne, Anyanwu, Philip, Costelloe, Céire, Moore, Michael, Hayhoe, Benedict, Pouwels, Koen B, Roope, Laurence SJ, Morrell, Liz, Hopkins, Susan, Butler, Christopher C and Walker, Ann Sarah (2023) Implementing antibiotic stewardship in high-prescribing English general practices : a mixed-methods study. British Journal of General Practice, 73 (728). e164-e175. doi:10.3399/BJGP.2022.0298 ISSN 0960-1643.
|
PDF
e164.full.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (849Kb) | Preview |
Official URL: http://dx.doi.org/10.3399/BJGP.2022.0298
Abstract
Background: Trials have identified antimicrobial stewardship (AMS) strategies that effectively reduce antibiotic use in primary care. However, many are not commonly used in England. The authors co-developed an implementation intervention to improve use of three AMS strategies: enhanced communication strategies, delayed prescriptions, and point-of-care C-reactive protein tests (POC-CRPTs).
Aim: To investigate the use of the intervention in high-prescribing practices and its effect on antibiotic prescribing.
Design and setting: Nine high-prescribing practices had access to the intervention for 12 months from November 2019. This was primarily delivered remotely via a website with practices required to identify an ‘antibiotic champion’.
Method: Routinely collected prescribing data were compared between the intervention and the control practices. Intervention use was assessed through monitoring. Surveys and interviews were conducted with professionals to capture experiences of using the intervention.
Results: There was no evidence that the intervention affected prescribing. Engagement with intervention materials differed substantially between practices and depended on individual champions’ preconceptions of strategies and the opportunity to conduct implementation tasks. Champions in five practices initiated changes to encourage use of at least one AMS strategy, mostly POC-CRPTs; one practice chose all three. POC-CRPTs was used more when allocated to one person.
Conclusion: Clinicians need detailed information on exactly how to adopt AMS strategies. Remote, one-sided provision of AMS strategies is unlikely to change prescribing; initial clinician engagement and understanding needs to be monitored to avoid misunderstanding and suboptimal use.
Item Type: | Journal Article | |||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RM Therapeutics. Pharmacology |
|||||||||||||||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | |||||||||||||||||||||
Library of Congress Subject Headings (LCSH): | Antibiotics, Drug resistance, Drugs -- Prescribing -- England, Drugs -- Prescribing -- Safety measures, Physicians (General practice) -- England | |||||||||||||||||||||
Journal or Publication Title: | British Journal of General Practice | |||||||||||||||||||||
Publisher: | Royal College of General Practitioners | |||||||||||||||||||||
ISSN: | 0960-1643 | |||||||||||||||||||||
Official Date: | March 2023 | |||||||||||||||||||||
Dates: |
|
|||||||||||||||||||||
Volume: | 73 | |||||||||||||||||||||
Number: | 728 | |||||||||||||||||||||
Page Range: | e164-e175 | |||||||||||||||||||||
DOI: | 10.3399/BJGP.2022.0298 | |||||||||||||||||||||
Status: | Peer Reviewed | |||||||||||||||||||||
Publication Status: | Published | |||||||||||||||||||||
Access rights to Published version: | Open Access (Creative Commons) | |||||||||||||||||||||
Date of first compliant deposit: | 3 May 2023 | |||||||||||||||||||||
Date of first compliant Open Access: | 10 May 2023 | |||||||||||||||||||||
RIOXX Funder/Project Grant: |
|
Request changes or add full text files to a record
Repository staff actions (login required)
View Item |
Downloads
Downloads per month over past year