Intervention planning for ARK (Antibiotic Review Kit): a digital and behavioural intervention to safely review and reduce antibiotic prescriptions in acute and general medicine

Autor: Santillo, M, Sivyer, K, Krusche, A, Mowbray, F, Jones, N, Peto, T E A, Walker, A S, Llewelyn, M J, Yardley, L, Lee, Amy, Sargent, Catherine, Butler, Chris, Roseveare, Chris, Agranoff, Daniel, Lockwood, Debbie, Lyon, Donald, Cross, Elizabeth, Darwin, Elizabeth, Barlow, Gavin, Setchfield, Ian, Islam, Jasmin, Wright, Juliet, Hand, Kieran, Vaughan, Louella, Wilcox, Mark, Wiselka, Martin, Sharland, Mike, Jones, Nicola, Fawcett, Nicola, Wade, Paul, Martin Dachsel, R, Sierra, Rachaeol, Bellamy, Richard, Pires, Sacha, Curtis, Sally, Lippett, Samantha, Crossland, Sue, Hopkins, Susan, Garcia-arias, Veronica, Gudka, Vikesh, Hamilton, Will, Gorton, Clifford
Jazyk: angličtina
Rok vydání: 2019
Předmět:
0301 basic medicine
General Practice
Antibiotics
pharmacists
feedback
antibiotics
law.invention
Antimicrobial Stewardship
0302 clinical medicine
Randomized controlled trial
law
Antimicrobial stewardship
Medicine
Pharmacology (medical)
030212 general & internal medicine
Qualitative Research
Original Research
transparency
behavioral health interventions
Hospitals
Anti-Bacterial Agents
Infectious Diseases
Digital Health
Physical and Mental Health
prescribing behavior
Microbiology (medical)
medicine.drug_class
Health Personnel
030106 microbiology
MEDLINE
Drug Prescriptions
nurses
03 medical and health sciences
Nursing
Stakeholder Participation
Intervention (counseling)
consultation
Humans
Medical prescription
Pharmacology
decision support techniques
business.industry
Health Plan Implementation
R1
Transparency (behavior)
United Kingdom
antimicrobial stewardship
business
Qualitative research
Zdroj: Santillo, M, Sivyer, K, Krusche, A, Mowbray, F, Jones, N, Peto, T E A, Walker, A S, Llewelyn, M J & Yardley, L 2019, ' Intervention planning for Antibiotic Review Kit (ARK) : a digital and behavioural intervention to safely review and reduce antibiotic prescriptions in acute and general medicine ', Journal of Antimicrobial Chemotherapy, vol. 74, no. 11, dkz333, pp. 3362-3370 . https://doi.org/10.1093/jac/dkz333
Santillo, M, Sivyer, K, Krusche, A, Mowbray, F, Jones, N, Peto, T E A, Walker, A S, Llewelyn, M J, Yardley, L, Lee, A, Sargent, C, Butler, C, Roseveare, C, Agranoff, D, Lockwood, D, Lyon, D, Cross, E, Darwin, E, Barlow, G, Setchfield, I, Islam, J, Wright, J, Hand, K, Vaughan, L, Wilcox, M, Wiselka, M, Sharland, M, Jones, N, Fawcett, N, Wade, P, Martin Dachsel, R, Sierra, R, Bellamy, R, Pires, S, Curtis, S, Lippett, S, Crossland, S, Hopkins, S, Garcia-arias, V, Gudka, V, Hamilton, W & Gorton, C 2019, ' Intervention planning for Antibiotic Review Kit (ARK): a digital and behavioural intervention to safely review and reduce antibiotic prescriptions in acute and general medicine ', Journal of Antimicrobial Chemotherapy, vol. 74, no. 11, pp. 3362-3370 . https://doi.org/10.1093/jac/dkz333
Journal of Antimicrobial Chemotherapy
ISSN: 0305-7453
1460-2091
DOI: 10.1093/jac/dkz333
Popis: BackgroundHospital antimicrobial stewardship strategies, such as ‘Start Smart, Then Focus’ in the UK, balance the need for prompt, effective antibiotic treatment with the need to limit antibiotic overuse using ‘review and revise’. However, only a minority of review decisions are to stop antibiotics. Research suggests that this is due to both behavioural and organizational factors.ObjectivesTo develop and optimize the Antibiotic Review Kit (ARK) intervention. ARK is a complex digital, organizational and behavioural intervention that supports implementation of ‘review and revise’ to help healthcare professionals safely stop unnecessary antibiotics.MethodsA theory-, evidence- and person-based approach was used to develop and optimize ARK and its implementation. This was done through iterative stakeholder consultation and in-depth qualitative research with doctors, nurses and pharmacists in UK hospitals. Barriers to and facilitators of the intervention and its implementation, and ways to address them, were identified and then used to inform the intervention’s development.ResultsA key barrier to stopping antibiotics was reportedly a lack of information about the original prescriber’s rationale for and their degree of certainty about the need for antibiotics. An integral component of ARK was the development and optimization of a Decision Aid and its implementation to increase transparency around initial prescribing decisions.ConclusionsThe key output of this research is a digital and behavioural intervention targeting important barriers to stopping antibiotics at review (see http://bsac-vle.com/ark-the-antibiotic-review-kit/ and http://antibioticreviewkit.org.uk/). ARK will be evaluated in a feasibility study and, if successful, a stepped-wedge cluster-randomized controlled trial at acute hospitals across the NHS.
Databáze: OpenAIRE
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