ArticleInfection control and hospital epidemiology2023
The use of telehealth-supported stewardship activities in acute-care and long-term care settings: An implementation effectiveness trial.
Article in Infection control and hospital epidemiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- Telemedicine interventions for improving antibiotic stewardship and prescribing: A systematic review.PloS one · 2025Pooled it
- Dissemination and Implementation of a Telehealth-Enabled Program for Providing Infectious Disease Expertise in Rural Settings.Open forum infectious diseases · 2025Trial
- Antibiotic stewardship practices at community living centers for veterans.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Research agenda for antibiotic stewardship within the Veterans' Health Administration, 2024-2028.Infection control and hospital epidemiology · 2024Article
- Diagnostic uncertainty and decision-making in home-based primary care: A qualitative study of antibiotic prescribing.Journal of the American Geriatrics Society · 2024Article
- Five steps to high quality antimicrobial stewardship research.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- Addressing Health-Related Social Needs in Hospitalized Children: An Implementation Assessment.Academic pediatricsArticle
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundWe assessed the implementation of telehealth-supported stewardship activities in acute-care units and long-term care (LTC) units in Veterans' Administration medical centers (VAMCs).
designBefore-and-after, quasi-experimental implementation effectiveness study with a baseline period (2019-2020) and an intervention period (2021).
settingThe study was conducted in 3 VAMCs without onsite infectious disease (ID) support.
participantsThe study included inpatient providers at participating sites who prescribe antibiotics.
interventionDuring 2021, an ID physician met virtually 3 times per week with the stewardship pharmacist at each participating VAMC to review patients on antibiotics in acute-care units and LTC units. Real-time feedback on prescribing antibiotics was given to providers. Additional implementation strategies included stakeholder engagement, education, and quality monitoring.
methodsThe reach-effectiveness-adoption-implementation-maintenance (RE-AIM) framework was used for program evaluation. The primary outcome of effectiveness was antibiotic days of therapy (DOT) per 1,000 days present aggregated across all 3 sites. An interrupted time-series analysis was performed to compare this rate during the intervention and baseline periods. Electronic surveys, periodic reflections, and semistructured interviews were used to assess other RE-AIM outcomes.
resultsThe telehealth program reviewed 502 unique patients and made 681 recommendations to 24 providers; 77% of recommendations were accepted. After program initiation, antibiotic DOT immediately decreased in the LTC units (-30%;
conclusionsThe implementation of our telehealth program was associated with reductions in antibiotic use in the LTC units but not in the smaller acute-care units. Overall, providers perceived the intervention as acceptable. Wider implementation of telehealth-supported stewardship activities may achieve reductions in antibiotic use.
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