Evidence map›Paper›PMID 37290780›Full record

ArticleBJGP open2023

Impact of the COVID-19 pandemic on antimicrobial stewardship support for general practices in England: a qualitative interview study.

Anne Campbell, Aleksandra J Borek, Monsey McLeod, Sarah Tonkin-Crine, Koen B Pouwels, Laurence Sj Roope, Benedict Wj Hayhoe, Azeem Majeed, A Sarah Walker, Alison Holmes and 1 more

Abstract read
In one paragraph

Article in BJGP open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

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

  1. Pooled it
  2. Article
  3. Article
  4. Article
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

11 authors.

Anne CampbellNational Institute for Health Research (NIHR), Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK.ORCID https://orcid.org/0000-0002-8893-4320
Aleksandra J BorekNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0001-6029-5291
Monsey McLeodNational Institute for Health Research (NIHR), Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK.ORCID https://orcid.org/0000-0001-5571-2417
Sarah Tonkin-CrineNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0003-4470-1151
Koen B PouwelsNuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0001-7097-8950
Laurence Sj RoopeNuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0001-9098-9331
Benedict Wj HayhoePrimary Care and Public Health, Imperial College London, London, UK.ORCID https://orcid.org/0000-0002-2645-6191
Azeem MajeedPrimary Care and Public Health, Imperial College London, London, UK.
A Sarah WalkerNIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0002-0412-8509
Alison HolmesNational Institute for Health Research (NIHR), Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK alison.holmes@imperial.ac.uk.ORCID https://orcid.org/0000-0001-5554-5743
STEP-UP team

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn England, clinical commissioning group (CCG; now replaced by Integrated Care Systems [ICSs]) and primary care network (PCN) professionals support primary care prescribers to optimise antimicrobial stewardship (AMS).

aimTo explore views and experiences of CCG and PCN staff in supporting AMS, and the impact of COVID-19 on this support. DESIGN &

settingQualitative interview study in primary care in England.

methodSemi-structured interviews with staff from CCG and PCNs responsible for AMS were conducted at two timepoints via telephone. These were audio-recorded, transcribed, and analysed thematically.

resultsTwenty-seven interviews were conducted with 14 participants (nine CCG, five PCN) in December 2020-January 2021 and February-May 2021. The study found that AMS support was (1) deprioritised in order to keep general practice operational and deliver COVID-19 vaccines; (2) disrupted as social distancing made it harder to build relationships, conduct routine AMS activities, and challenge prescribing decisions; and (3) adapted, with opportunities identified for greater use of technology and changing patient and public perceptions of viruses and self-care. It was also found that resources to support AMS were valued if they were both novel, to counter AMS 'fatigue', and sufficiently familiar to fit with existing and/or future AMS.

conclusionAMS needs to be reprioritised in general practice in the post-pandemic era and within the new ICSs in England. This should include interventions and strategies that combine novel elements with already familiar strategies to refresh prescribers' motivation and opportunities for AMS. Behaviour change interventions should be aimed at improving the culture and processes for how PCN pharmacists voice concerns about AMS to prescribers in general practice and take advantage of the changed patient and public perceptions of viruses and self-care.

Indexed as

antibioticsantimicrobial stewardshipCOVID-19general practicequalitative research

Identifiers

PMID37290780
PMCPMC10646204

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.