Scientific Publications Database

Article 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. L.; Xu, Alice X. T.; Alderson, Sarah; Bjerrum, Lars; Brehaut, Jamie; Brown, Benjamin C. C.; Bucher, Heiner C. C.; De Sutter, An; Francis, Nick; Grimshaw, Jeremy; Gunnarsson, Ronny; Hoye, Sigurd; Ivers, Noah; Lecky, Donna M. M.; Lindbaek, Morten; Linder, Jeffrey A. A.; Little, Paul; Michalsen, Benedikte Olsen; O'Connor, Denise; Pulcini, Celine; Sundvall, Par-Daniel; Lundgren, Pia Touboul; Verbakel, Jan Y. Y.; Verheij, Theo J. J.
Journal: ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL Volume 12 Issue 1
Date of Publication:2023
Abstract:
BackgroundPrimary 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.ObjectiveTo 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.MethodsWe 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.ResultsThe 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).ConclusionWe 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.