Behavioural approaches to optimise antibiotic stewardship in hospitals
Antibiotic stewardship is seen as a key strategy to prevent antibiotic resistance and reduce healthcare associated infections. Our group has recently completed the most comprehensive systematic review to date of 221 intervention studies to improve hospital antibiotic prescribing. The results are clear - we have robust evidence to show that a variety of interventions are effective in reducing unnecessary treatment safely, without increase in mortality. However there are likely further opportunities to enhance the effects of such programs. There is a substantial theoretical and empirical framework in behavioural sciences about how to change behaviour, yet the extent to which current antibiotic stewardship programs have adopted a behavioural approach is uncertain. There is an urgent need to bring together key stakeholders in the delivery of stewardship programmes and research experts in improvement sciences to develop more impactful stewardship programmes. This working group comprising world experts in antibiotic stewardship from UK, Canada, Norway, and Germany in partnership with experts in implementation science and behaviour change interventions aims to address the following: 1. What behaviour change approaches can be recommended now to optimise hospital stewardship programmes? 2. How can hospital stewardship programmes be designed to optimise implementation across countries? 3. What is the research agenda to optimise efficient implementation of hospital antibiotic stewardship programmes worldwide?
- Craig R Ramsay, University of Aberdeen, United Kingdom (Coordinator)
- Charis A Marwick, University of Dundee, United Kingdom (Observer)
- Ralph Möhler, University of Freiberg, Germany (Observer)
- Peter Davey, University of Dundee, United Kingdom (Observer)
- Esmita Charani, Imperial College London, United Kingdom (Observer)
- Jeremy Grimshaw, Ottawa Hospital Research Institute, Canada (Observer)
- Andrew Morris, University of Toronto, Canada (Observer)
- Ingrid Smith, University of Bergen, Norway (Observer)
- Brita Skodvin, University of Bergen, Norway (Observer)
- Winfried V Kern, Albert-Ludwigs University, Germany (Observer)
- Jill J Francis, City University London, United Kingdom (Observer)
Antibiotics are used to treat infections, such as pneumonia, that are caused by bacteria. Over time, however, many bacteria have become resistant to antibiotics. Antibiotic resistance is a serious problem for individual patients and healthcare systems; in hospitals, infections caused by antibiotic‐resistant bacteria are associated with higher rates of death, illness and prolonged hospital stay. Bacteria often become resistant because antibiotics are used too often and incorrectly.Antibiotic stewardship is seen as a key strategy to prevent antibiotic resistance. This Joint Programming Initiative for Antimicrobial Resistance funded international working group comprised world experts in antibiotic stewardship from UK, Canada, Norway, and Germany in partnership with experts in implementation science and behaviour change interventions. The working group identified and agreed research priorities for future research efforts to optimise behavioural approaches to the implementation of antibiotic stewardship in hospitals worldwide. The research priorities were grouped into three areas: 1) establishing the evidence base and understanding current practice; 2) design and evaluation of stewardship programmes and 3) crosscutting areas such as what matters to patients in stewardship programmes.
- Clinical Microbiology and Infection, 2018. Prioritizing research areas for antibiotic stewardship programmes in hospitals: a behavioural perspective consensus paper
- Journal of Antimicrobial Chemotherapy, 2020. A behavioural approach to specifying interventions: what insights can be gained for the reporting and implementation of interventions to reduce antibiotic use in hospitals?
- Front. Sociol, 2020. Barriers and Facilitators to Implementation of Antibiotic Stewardship Programmes in Hospitals in Developed Countries