Best practice guidance for antibiotic audit and feedback interventions in primary care: a modified Delphi study from the Joint Programming Initiative on Antimicrobial resistance: Primary Care Antibiotic Audit and Feedback Network (JPIAMR-PAAN)

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...

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Detalles Bibliográficos
Autores principales: Schwartz, Kevin L., Xu, Alice X. T., Alderson, Sarah, Bjerrum, Lars, Brehaut, Jamie, Brown, Benjamin C., Bucher, Heiner C., De Sutter, An, Francis, Nick, Grimshaw, Jeremy, Gunnarsson, Ronny, Hoye, Sigurd, Ivers, Noah, Lecky, Donna M., Lindbæk, Morten, Linder, Jeffrey A., Little, Paul, Michalsen, Benedikte Olsen, O’Connor, Denise, Pulcini, Celine, Sundvall, Pär-Daniel, Lundgren, Pia Touboul, Verbakel, Jan Y., Verheij, Theo J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Research
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10387210/
https://www.ncbi.nlm.nih.gov/pubmed/37516892
http://dx.doi.org/10.1186/s13756-023-01279-z
Descripción
Sumario: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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13756-023-01279-z.

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