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- Title
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).
- Authors
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
- Abstract
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.
- Subjects
DRUG resistance in microorganisms; BEST practices; PRIMARY care; HIGH-income countries; INAPPROPRIATE prescribing (Medicine)
- Publication
Antimicrobial Resistance & Infection Control, 2023, Vol 12, Issue 1, p1
- ISSN
2047-2994
- Publication type
Article
- DOI
10.1186/s13756-023-01279-z