ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2023
Implementing antibiotic stewardship in high-prescribing English general practices: a mixed-methods study.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
What it found
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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
8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 11 citations in OpenAlex.
- A systematic review of national interventions and policies to optimize antibiotic use in healthcare settings in England.The Journal of antimicrobial chemotherapy · 2024Pooled it
- Improving healthcare professionals' interactions with patients to tackle antimicrobial resistance: a systematic review of interventions, barriers, and facilitators.Frontiers in public health · 2024Pooled it
- Implementation of the CHIldren with acute COugh (CHICO) intervention to improve antibiotics management: a qualitative study in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Trial
- Development of 'Location of Dialysis Care in Kidney Life', a service delivery intervention to eliminate unwarranted variation in home dialysis uptake between kidney services and to optimise home dialysis use.BMC health services research · 2026Article
- Barriers and facilitators of the implementation for the antimicrobial Social Norm Feedback (SNF) intervention strategy in primary care institutions: a qualitative study based on the Consolidated Framework for Implementation Research (CFIR).Antimicrobial resistance and infection control · 2025Article
- Implementing in-vitro diagnostic point-of-care tests in community health care: how can we make this work?The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Impact of the COVID-19 pandemic on antimicrobial stewardship support for general practices in England: a qualitative interview study.BJGP open · 2023Article
- Antibiotic stewardship: where next?The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Article
Corrections and comments
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Authors and funding
15 authors at 8 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTrials 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).
aimTo investigate the use of the intervention in high-prescribing practices and its effect on antibiotic prescribing. DESIGN AND
settingNine 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'.
methodRoutinely 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.
resultsThere 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.
conclusionClinicians 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.
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Registered trials
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