Awareness, perception, and barriers of healthcare providers toward the revised consensus guideline for therapeutic monitoring of vancomycin

BACKGROUND: A revised consensus guideline published in 2020 recommended transitioning vancomycin monitoring to the area under the concentration–time curve over 24 h to minimum inhibitory concentration (AUC(24)/MIC). The decision to transition to AUC(24)/MIC monitoring or to continue trough-based monitoring is made at the institutional level and is influenced by several factors, including healthcare providers and system-related factors. Changing current practices is expected to be difficult, and it is important to understand healthcare providers’ perceptions and potential barriers before the transition. This study assessed the awareness and perception of physicians and pharmacists toward the revised guideline and identified barriers to their implementation in Kuwait. METHODS: A cross-sectional survey that employed a self-administered questionnaire was used. A random sample of physicians (n = 390), clinical microbiologists (n = 37), and clinical pharmacists (n = 48) across six Kuwaiti public hospitals were surveyed. Descriptive and comparative statistical analyses were performed. Factors associated with awareness and perceptions among the participants were identified. RESULTS: The response rate was 85.3% (n = 431). Participants had a high (median = 75%) awareness score for the updated vancomycin guideline, as well as a positive perception (median = 5). The main factor identified to affect the awareness and perception of participants following the group analysis was the years of experience. The main barriers identified were a lack of training to perform vancomycin AUC(24) calculations, a lack of accurate documentation sample time, and a long turnaround time for serum levels, which might hinder the implementation of the updated guideline. CONCLUSION: Physicians, clinical microbiologists, and pharmacists working in Kuwait public hospitals were aware of the 2020 vancomycin monitoring guidelines with positive perceptions. Participants agreed on the several barriers to transitioning to the AUC(24)/MIC approach, which should be considered by stakeholders before implementation.