SynthesisJournal of the American Board of Family Medicine : JABFM
Ambulatory Antibiotic Stewardship through a Human Factors Engineering Approach: A Systematic Review.
Synthesis in Journal of the American Board of Family Medicine : JABFM. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- A systematic literature review and meta-analysis of community pharmacist-led interventions to optimise the use of antibiotics.British journal of clinical pharmacology · 2022Pooled it
- Development of an antimicrobial stewardship implementation model involving collaboration between general practitioners and pharmacists: GPPAS study in Australian primary care.Primary health care research & development · 2021Pooled it
- Factors associated with antibiotic prescribing for adults with acute conditions: an umbrella review across primary care and a systematic review focusing on primary dental care.The Journal of antimicrobial chemotherapy · 2019Pooled it
- The latent system factors that influence antimicrobial use and governance in healthcare: a scoping review of high-income health systems.EClinicalMedicine · 2025Review
- Standard vs. enhanced implementation strategies to increase adoption of a multidrug-resistant organism alert tool: a cluster randomized trial.Frontiers in health services · 2025Article
- How, why and when are delayed (back-up) antibiotic prescriptions used in primary care? A realist review integrating concepts of uncertainty in healthcare.BMC public health · 2024Review
- Barriers to Implementing Registered Nurse-Driven Clinical Decision Support for Antibiotic Stewardship: Retrospective Case Study.JMIR formative research · 2024Article
- Reducing prescribing of antibiotics for acute respiratory infections using a frontline nurse-led EHR-Integrated clinical decision support tool: protocol for a stepped wedge randomized control trial.BMC medical informatics and decision making · 2023Article
- Deep Dive Into Gaps and Barriers to Implementation of Antimicrobial Stewardship Programs in Hospitals in Latin America.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- A Novel GPPAS Model: Guiding the Implementation of Antimicrobial Stewardship in Primary Care Utilising Collaboration between General Practitioners and Community Pharmacists.Antibiotics (Basel, Switzerland) · 2022Article
- Don't just do it-Conducting and publishing improvement science in infection prevention and antibiotic stewardship.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2022Review
- Antimicrobial stewardship in Latin America: Past, present, and future.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2022Review
- The Five Ds of Outpatient Antibiotic Stewardship for Urinary Tract Infections.Clinical microbiology reviews · 2021Review
- Nurse practitioners as antibiotic stewards: Examining prescribing patterns and perceptions.American journal of infection control · 2021Article
- Operationalising outpatient antimicrobial stewardship to reduce system-wide antibiotics for acute bronchitis.BMJ open quality · 2021Article
- Implementation of An Antibiotic Stewardship Intervention to Reduce Prescription of Fluoroquinolones: A Human Factors Analysis in Two Intensive Care Units.Journal of patient safety and risk management · 2021Article
- Development and evaluation of a primary care antimicrobial stewardship program (PC-ASP) in Toronto, Ontario, Canada.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2021Article
- Feasibility and Validity of a Framework for Antimicrobial Stewardship in General Practice: Key Stakeholder Interviews.Antibiotics (Basel, Switzerland) · 2020Article
- Antimicrobial Stewardship in General Practice: A Scoping Review of the Component Parts.Antibiotics (Basel, Switzerland) · 2020Article
- A Nationwide Survey of Australian General Practitioners on Antimicrobial Stewardship: Awareness, Uptake, Collaboration with Pharmacists and Improvement Strategies.Antibiotics (Basel, Switzerland) · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
introductionIn the United States, most antibiotics are prescribed in ambulatory settings. Human factors engineering, which explores interactions between people and the place where they work, has successfully improved quality of care. However, human factors engineering models have not been explored to frame what is known about ambulatory antibiotic stewardship (AS) interventions and barriers and facilitators to their implementation.
methodsWe conducted a systematic review and searched OVID MEDLINE, Embase, Scopus, Web of Science, and CINAHL to identify controlled interventions and qualitative studies of ambulatory AS and determine whether and how they incorporated principles from a human factors engineering model, the Systems Engineering Initiative for Patient Safety 2.0 model. This model describes how a work system (ambulatory clinic) contributes to a process (antibiotic prescribing) that leads to outcomes. The work system consists of 5 components, tools and technology, organization, person, tasks, and environment, within an external environment.
resultsOf 1,288 abstracts initially identified, 42 quantitative studies and 17 qualitative studies met inclusion criteria. Effective interventions focused on tools and technology (eg, clinical decision support and point-of-care testing), the person (eg, clinician education), organization (eg, audit and feedback and academic detailing), tasks (eg, delayed antibiotic prescribing), the environment (eg, commitment posters), and the external environment (media campaigns). Studies have not focused on clinic-wide approaches to AS.
conclusionsA human factors engineering approach suggests that investigating the role of the clinic's processes or physical layout or external pressures' role in antibiotic prescribing may be a promising way to improve ambulatory AS.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.