Evidence map›Paper›PMID 31683590›Full record

ArticleAntibiotics (Basel, Switzerland)2019

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 and 4 more

Abstract read
In one paragraph

Article in Antibiotics (Basel, Switzerland), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Aleksandra J BorekNuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford OX2 6GG, UK. aleksandra.borek@phc.ox.ac.uk.ORCID 0000-0001-6029-5291
Marta WanatNuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford OX2 6GG, UK. marta.wanat@phc.ox.ac.uk.
Anna SallisPublic Health England Behavioural Insights, London SE1 8UG, UK. Anna.Sallis@phe.gov.uk.
Diane Ashiru-OredopePublic Health England, London SE1 8UG, UK. Diane.Ashiru-Oredope@phe.gov.uk.ORCID 0000-0001-9579-2028
Lou AtkinsCentre for Behaviour Change, University College London, London WC1E 6BT, UK. l.atkins@ucl.ac.uk.
Elizabeth BeechNHS England and NHS Improvement, London SE1 6LH, UK. elizabeth.beech@nhs.net.
Susan HopkinsPublic Health England, London SE1 8UG, UK. Susan.Hopkins@phe.gov.uk.
Leah JonesPublic Health England, London SE1 8UG, UK. Leah.Jones@phe.gov.uk.ORCID 0000-0002-0448-3471
Cliodna McNultyPublic Health England, London SE1 8UG, UK. Cliodna.McNulty@phe.gov.uk.ORCID 0000-0003-4969-5360
Karen ShawPublic Health England, London SE1 8UG, UK. k.shaw7@nhs.net.
Esther TabornNHS England and NHS Improvement, London SE1 6LH, UK. esther.taborn@nhs.net.
Christopher ButlerNuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford OX2 6GG, UK. christopher.butler@phc.ox.ac.uk.
Tim ChadbornPublic Health England Behavioural Insights, London SE1 8UG, UK. Tim.Chadborn@phe.gov.uk.
Sarah Tonkin-CrineNuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford OX2 6GG, UK. sarah.tonkin-crine@phc.ox.ac.uk.ORCID 0000-0003-4470-1151

Funding

Public Health England n/a
6 · The paper itself

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.

Indexed as

antibiotic prescribingantimicrobial stewardshipbehavior changeimplementationprimary carestakeholder consultation

Identifiers

PMID31683590
PMCPMC6963414

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.