TY - JOUR
T1 - Best practice guidance for antibiotic audit and feedback interventions in primary care
T2 - a modified Delphi study from the Joint Programming Initiative on Antimicrobial resistance: Primary Care Antibiotic Audit and Feedback Network (JPIAMR-PAAN)
AU - Schwartz, Kevin L.
AU - Xu, Alice X.T.
AU - Alderson, Sarah
AU - Bjerrum, Lars
AU - Brehaut, Jamie
AU - Brown, Benjamin C.
AU - Bucher, Heiner C.
AU - De Sutter, An
AU - Francis, Nick
AU - Grimshaw, Jeremy
AU - Gunnarsson, Ronny
AU - Hoye, Sigurd
AU - Ivers, Noah
AU - Lecky, Donna M.
AU - Lindbæk, Morten
AU - Linder, Jeffrey A.
AU - Little, Paul
AU - Michalsen, Benedikte Olsen
AU - O’Connor, Denise
AU - Pulcini, Celine
AU - Sundvall, Pär Daniel
AU - Lundgren, Pia Touboul
AU - Verbakel, Jan Y.
AU - Verheij, Theo J.
N1 - Publisher Copyright:
© 2023, Crown.
PY - 2023/7
Y1 - 2023/7
N2 - Background: Primary care is a critical partner for antimicrobial stewardship efforts given its high human antibiotic usage. Peer comparison audit and feedback (A&F) is often used to reduce inappropriate antibiotic prescribing. The design and implementation of A&F may impact its effectiveness. There are no best practice guidelines for peer comparison A&F in antibiotic prescribing in primary care. Objective: To develop best practice guidelines for peer comparison A&F for antibiotic prescribing in primary care in high income countries by leveraging international expertise via the Joint Programming Initiative on Antimicrobial Resistance—Primary Care Antibiotic Audit and Feedback Network. Methods: We used a modified Delphi process to achieve convergence of expert opinions on best practice statements for peer comparison A&F based on existing evidence and theory. Three rounds were performed, each with online surveys and virtual meetings to enable discussion and rating of each best practice statement. A five-point Likert scale was used to rate consensus with a median threshold score of 4 to indicate a consensus statement. Results: The final set of guidelines include 13 best practice statements in four categories: general considerations (n = 3), selecting feedback recipients (n = 1), data and indicator selection (n = 4), and feedback delivery (n = 5). Conclusion: We report an expert-derived best practice recommendations for designing and evaluating peer comparison A&F for antibiotic prescribing in primary care. These 13 statements can be used by A&F designers to optimize the impact of their quality improvement interventions, and improve antibiotic prescribing in primary care.
AB - Background: Primary care is a critical partner for antimicrobial stewardship efforts given its high human antibiotic usage. Peer comparison audit and feedback (A&F) is often used to reduce inappropriate antibiotic prescribing. The design and implementation of A&F may impact its effectiveness. There are no best practice guidelines for peer comparison A&F in antibiotic prescribing in primary care. Objective: To develop best practice guidelines for peer comparison A&F for antibiotic prescribing in primary care in high income countries by leveraging international expertise via the Joint Programming Initiative on Antimicrobial Resistance—Primary Care Antibiotic Audit and Feedback Network. Methods: We used a modified Delphi process to achieve convergence of expert opinions on best practice statements for peer comparison A&F based on existing evidence and theory. Three rounds were performed, each with online surveys and virtual meetings to enable discussion and rating of each best practice statement. A five-point Likert scale was used to rate consensus with a median threshold score of 4 to indicate a consensus statement. Results: The final set of guidelines include 13 best practice statements in four categories: general considerations (n = 3), selecting feedback recipients (n = 1), data and indicator selection (n = 4), and feedback delivery (n = 5). Conclusion: We report an expert-derived best practice recommendations for designing and evaluating peer comparison A&F for antibiotic prescribing in primary care. These 13 statements can be used by A&F designers to optimize the impact of their quality improvement interventions, and improve antibiotic prescribing in primary care.
UR - http://www.scopus.com/inward/record.url?scp=85165978540&partnerID=8YFLogxK
U2 - 10.1186/s13756-023-01279-z
DO - 10.1186/s13756-023-01279-z
M3 - Article
C2 - 37516892
AN - SCOPUS:85165978540
SN - 2047-2994
VL - 12
JO - Antimicrobial Resistance and Infection Control
JF - Antimicrobial Resistance and Infection Control
IS - 1
M1 - 72
ER -