Evidence map›Paper›PMID 39758875›Full record

ReviewAntimicrobial stewardship & healthcare epidemiology : ASHE2024

Navigating performance measures for ambulatory antimicrobial stewardship: a review of HEDIS® and other metrics the steward should know.

Christen J Arena, Michael P Veve, Steven T Fried, Felisa Ware, Patricia Lee, Anita B Shallal

Abstract readReview
In one paragraph

Review in Antimicrobial stewardship & healthcare epidemiology : ASHE, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. 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

6 authors.

Christen J ArenaDepartment of Pharmacy, Henry Ford Hospital, Detroit, MI, USA.ORCID https://orcid.org/0009-0002-9787-358X
Michael P VeveDepartment of Pharmacy, Henry Ford Hospital, Detroit, MI, USA.ORCID https://orcid.org/0000-0001-5967-5211
Steven T FriedDepartment of Family Medicine, Henry Ford Health, Detroit, MI, USA.
Felisa WareDepartment of Payer Relations and Practice Transformation, Henry Ford Health, Detroit, MI, USA.
Patricia LeeDepartment of Pharmacy, Henry Ford Hospital, Detroit, MI, USA.ORCID https://orcid.org/0000-0001-9353-9651
Anita B ShallalDepartment of Infectious Diseases, Henry Ford Hospital, Detroit, MI, USA.ORCID https://orcid.org/0000-0002-1940-3622

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Ambulatory antimicrobial stewardship can be challenging due to disparities in resource allocation across the care continuum, competing priorities for ambulatory prescribers, ineffective communication strategies, and lack of incentive to prioritize antimicrobial stewardship program (ASP) initiatives. Efforts to monitor and compare outpatient antibiotic usage metrics have been implemented through quality measures (QM). Healthcare Effectiveness Data and Information Set (HEDIS®) represent standardized measures that examine the quality of antibiotic prescribing by region and across insurance health plans. Health systems with affiliated emergency departments and ambulatory clinics contribute patient data for HEDIS measure assessment and are directly related to value-based reimbursement, pay-for-performance, patient satisfaction measures, and payor incentives and rewards. There are four HEDIS® measures related to optimal antibiotic prescribing in upper respiratory tract diseases that ambulatory ASPs can leverage to develop and measure effective interventions while maintaining buy-in from providers: avoidance of antibiotic treatment for acute bronchitis/bronchiolitis, appropriate treatment for upper respiratory infection, appropriate testing for pharyngitis, and antibiotic utilization for respiratory conditions. Additionally, there are other QM assessed by the Centers for Medicare and Medicaid Services (CMS), including overuse of antibiotics for adult sinusitis. Ambulatory ASPs with limited resources should leverage HEDIS® to implement and measure successful interventions due to their pay-for-performance nature. The purpose of this review is to outline the HEDIS® measures related to infectious diseases in ambulatory care settings. This review also examines the barriers and enablers in ambulatory ASPs which play a crucial role in promoting responsible antibiotic use and the efforts to optimize patient outcomes.

Identifiers

PMID39758875
PMCPMC11696599

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Registered trials

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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.