Local implementation of national AMS initiatives across CCGs: a mixed-methods study
Author(s): ,
Rosalie Allison
Affiliations:
Public Health England
,
Donna Lecky
Affiliations:
Public Health England
,
Elizabeth Beech
Affiliations:
NHS Improvements
,
Ceire Costelloe
Affiliations:
Imperial College London
,
Diane Ashiru-Oredope
Affiliations:
Public Health England
,
Rebecca Owens
Affiliations:
Public Health England
Cliodna McNulty
Affiliations:
Public Health England
PHE ePoster Library. Allison R. 03/20/18; 205894; 12520
Rosalie Allison
Rosalie Allison
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Abstract
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Abstract BackgroundThe NHS English Quality Premium recommends that inappropriate antibiotic prescribing is reduced; there are a range of national antimicrobial stewardship (AMS) initiatives to support this.AimThe aim of this study is to assess AMS activities in primary care across England. The findings will be used to inform how the RCGP, PHE and NHS can help optimise stewardship activities.MethodsQualitative interviews: schedule developed by the multidisciplinary team and piloted. Clinical Commissioning Groups (CCGs) were stratified into quintiles according to overall antibacterial prescribing (ITEMS/STAR-PU) and approached in a random order from this list. Interviews were undertaken with AMS leads within Clinical Commissioning Groups' (CCGs) and Commissioning Support Units' (CSUs) medicines management teams across England.Questionnaire: informed by the qualitative data, sent to all 209 CCGs in England in 2017.Results and Implications11 AMS leads were interviewed and 187/209 (89%) of CCGs returned a questionnaire.Activities reported:99% (184/186) actively promoted the TARGET Antibiotics Toolkit.94% (175/187) actively promoted TARGET patient leaflets; 92% The Treating Your Infection (TYI) leaflet. 65/161 (40%) had integrated the TYI-RTI leaflet into clinical systems - there is an opportunity to improve this to increase uptake of use.90% (166/185) used the PHE managing common infections guidance: 81% (149/185) modify or localise; 41/185 (22%) signpost directly to it.All bar 2 had delivered AMS education in the last 2 years: 131 face-to-face; 120 via e-learning.85% (142/168) fed back antimicrobial prescribing data to the CCG/CSU board; 100% (169/169) to general practices and 33% (56/169) to out of hours providers.86 used CCG audit tools and 82 used TARGET's audit tools.Although CCGs reported promoting these AMS activities, there was little evaluation of uptake by primary care practitioners. Future work should focus on measuring AMS uptake. Funding Research supported by Public Health England.
Abstract BackgroundThe NHS English Quality Premium recommends that inappropriate antibiotic prescribing is reduced; there are a range of national antimicrobial stewardship (AMS) initiatives to support this.AimThe aim of this study is to assess AMS activities in primary care across England. The findings will be used to inform how the RCGP, PHE and NHS can help optimise stewardship activities.MethodsQualitative interviews: schedule developed by the multidisciplinary team and piloted. Clinical Commissioning Groups (CCGs) were stratified into quintiles according to overall antibacterial prescribing (ITEMS/STAR-PU) and approached in a random order from this list. Interviews were undertaken with AMS leads within Clinical Commissioning Groups' (CCGs) and Commissioning Support Units' (CSUs) medicines management teams across England.Questionnaire: informed by the qualitative data, sent to all 209 CCGs in England in 2017.Results and Implications11 AMS leads were interviewed and 187/209 (89%) of CCGs returned a questionnaire.Activities reported:99% (184/186) actively promoted the TARGET Antibiotics Toolkit.94% (175/187) actively promoted TARGET patient leaflets; 92% The Treating Your Infection (TYI) leaflet. 65/161 (40%) had integrated the TYI-RTI leaflet into clinical systems - there is an opportunity to improve this to increase uptake of use.90% (166/185) used the PHE managing common infections guidance: 81% (149/185) modify or localise; 41/185 (22%) signpost directly to it.All bar 2 had delivered AMS education in the last 2 years: 131 face-to-face; 120 via e-learning.85% (142/168) fed back antimicrobial prescribing data to the CCG/CSU board; 100% (169/169) to general practices and 33% (56/169) to out of hours providers.86 used CCG audit tools and 82 used TARGET's audit tools.Although CCGs reported promoting these AMS activities, there was little evaluation of uptake by primary care practitioners. Future work should focus on measuring AMS uptake. Funding Research supported by Public Health England.
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