Behaviour change interventions to influence antimicrobial prescribing: a cross-sectional analysis of reports from UK state-of-the-art scientific conferences

Rawson, Timothy M; Moore, Luke; Tivey, Ann; Tsao, Adam; Gilchrist, Mark; Charani, Esmita; Holmes, Alison

doi:10.1186/s13756-017-0170-7

Cited by 40 publications

(30 citation statements)

References 24 publications

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“…While clear data regarding optimal practices are lacking for equine arthroscopy, general principles of antimicrobial use and extrapolation from other species provide evidence that there is room for marked changes in use practices, at least at this institution. Development and assessment of interventions is beyond the scope of this study and is a complex area that involves many potential areas, including behavioral aspects . Development and testing of interventions is an important area in equine medicine and surgery, but is a very underdeveloped field.…”

Section: Discussionmentioning

confidence: 99%

Retrospective assessment of perioperative antimicrobial use for elective arthroscopy in horses

2020

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Objective To describe perioperative antimicrobial use in horses undergoing elective arthroscopy. Study design. Retrospective study. Sample population. Horses that underwent elective arthroscopy at one institution between July 2016 and May 2018, excluding those with a suspected infectious orthopedic disease or with a comorbidity that may have impacted prophylactic antimicrobial use decisions. Methods Medical records were reviewed to evaluate preoperative, intraoperative, and postoperative antimicrobial drug selection, dose, and timing. Associations between body weight and underdosing were evaluated by using analysis of variance, χ2 test was used for categorical comparisons, and least squares fit was used to evaluate factors associated with duration of postoperative antimicrobials. Results Among 150 horses, 149 (99.3%) received systemic preoperative antimicrobials. Only 53 (40.2%) horses were administered doses within 60 minutes of surgical incision. First incision was performed more than two half‐lives after administration of sodium penicillin in 46 of 131 (35.1%) horses but in only 1 of 106 (0.8%) horses that received trimethoprim‐sulfadoxine. Body weight was associated with underdosing for penicillin (P = .0075) and trimethoprim‐sulfadoxine (P = .002) but not gentamicin (P = .92). Twenty‐six (17%) horses received one postoperative antimicrobial dose, while antimicrobials were continued in hospital for a mean of 22.3 ± 4.4 hours after surgery in the other 123 horses. Among the 149 discharged horses, 115 (77.2%) were prescribed antimicrobials after discharge (range, 3‐10 days; median, 3 days, interquartile range, 0 days). Conclusion Deviations from common recommendations were apparent and provide evidence for the requirement to develop interventions to optimize perioperative prophylaxis. Clinical significance Perioperative antimicrobial use practices should be regularly assessed to provide a benchmark and identify areas for intervention.

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Section: Discussionmentioning

confidence: 99%

Retrospective assessment of perioperative antimicrobial use for elective arthroscopy in horses

2020

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“…Within the AMR public health interventions literature, there is also a lack of transparency regarding key intervention components (Rawson et al, 2017). These 'active ingredients' explain how an intervention exerts its effects (Craig et al, 2008), representing the proposed 'mechanisms of change' underpinning interventions.…”

Section: Statement Of Contributionmentioning

confidence: 99%

What are the ‘active ingredients’ of interventions targeting the public's engagement with antimicrobial resistance and how might they work?

McParland

Williams

Gozdzielewska

et al. 2018

British J Health Psychol

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ObjectivesChanging public awareness of antimicrobial resistance (AMR) represents a global public health priority. A systematic review of interventions that targeted public AMR awareness and associated behaviour was previously conducted. Here, we focus on identifying the active content of these interventions and explore potential mechanisms of action.MethodsThe project took a novel approach to intervention mapping utilizing the following steps: (1) an exploration of explicit and tacit theory and theoretical constructs within the interventions using the Theoretical Domains Framework (TDFv2), (2) retrospective coding of behaviour change techniques (BCTs) using the BCT Taxonomy v1, and (3) an investigation of coherent links between the TDF domains and BCTs across the interventions.ResultsOf 20 studies included, only four reported an explicit theoretical basis to their intervention. However, TDF analysis revealed that nine of the 14 TDF domains were utilized, most commonly ‘Knowledge’ and ‘Environmental context and resources’. The BCT analysis showed that all interventions contained at least one BCT, and 14 of 93 (15%) BCTs were coded, most commonly ‘Information about health consequences’, ‘Credible source’, and ‘Instruction on how to perform the behaviour’.ConclusionsWe identified nine relevant TDF domains and 14 BCTs used in these interventions. Only 15% of BCTs have been applied in AMR interventions thus providing a clear opportunity for the development of novel interventions in this context. This methodological approach provides a useful way of retrospectively mapping theoretical constructs and BCTs when reviewing studies that provide limited information on theory and intervention content. Statement of contribution What is already known on this subject? Evidence of the effectiveness of interventions that target the public to engage them with AMR is mixed; the public continue to show poor knowledge and misperceptions of AMR.Little is known about the common, active ingredients of AMR interventions targeting the public and information on explicit theoretical content is sparse.Information on the components of AMR public health interventions is urgently needed to enable the design of effective interventions to engage the public with AMR stewardship behaviour. What does this study add? The analysis shows very few studies reported any explicit theoretical basis to the interventions they described.Many interventions share common components, including core mechanisms of action and behaviour change techniques.The analysis suggests components of future interventions to engage the public with AMR.

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“…We propose ten research priorities areasdshared by clinicians as well as clinical and nonclinical academics from HICs with publicly funded healthcare systemsdfor future research on hospital ASPs. For this we focused on a behavioural science perspective, a mode currently underutilized in antibiotic stewardship studies [3,14,15,32]. This way, we addressed a recognized important gap in knowledge [14].…”

Section: Discussionmentioning

confidence: 99%

Prioritizing research areas for antibiotic stewardship programmes in hospitals: a behavioural perspective consensus paper

Rzewuska

Charani

Clarkson

et al. 2019

Clinical Microbiology and Infection

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Behaviour change interventions to influence antimicrobial prescribing: a cross-sectional analysis of reports from UK state-of-the-art scientific conferences

Cited by 40 publications

References 24 publications

Retrospective assessment of perioperative antimicrobial use for elective arthroscopy in horses

Retrospective assessment of perioperative antimicrobial use for elective arthroscopy in horses

What are the ‘active ingredients’ of interventions targeting the public's engagement with antimicrobial resistance and how might they work?

Prioritizing research areas for antibiotic stewardship programmes in hospitals: a behavioural perspective consensus paper

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