Lesley A Hawes1,2, Jaclyn Bishop2,3,4, Kirsty Buising2,5,6, Danielle Mazza1,2. 1. Department of General Practice, School of Primary and Allied Health Care, Monash University, Level 1, 270 Ferntree Gully Road, Notting Hill, Victoria 3168, Australia. 2. National Centre for Antimicrobial Stewardship, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Level 5, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia. 3. Department of Medicine-Royal Melbourne Hospital, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Royal Parade, Melbourne, Victoria 3050, Australia. 4. Pharmacy Department, Ballarat Health Services, Drummond Street, Ballarat, Victoria 3350, Australia. 5. Victorian Infectious Diseases Service, Royal Melbourne Hospital, 300 Grattan St, Parkville, Victoria 3050, Australia. 6. Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria 3010, Australia.
Abstract
There is little guidance about developing systems for antimicrobial stewardship (AMS) for general practice. A literature review identified six key components: governance, monitoring of antibiotic prescribing and resistance with feedback to prescribers, consultation support, education of the public and general practitioners, pharmacist and nurse involvement, and research, which were incorporated into a potential framework for the general practice context. Objectives: to determine the feasibility and validity of the proposed AMS framework. A secondary objective was to identify likely bodies responsible for implementation in Australia. We undertook interviews with 12 key stakeholders from government, research, and professional groups. Data were analysed with a thematic approach. The framework was considered valid and feasible. No clear organisation was identified to lead AMS implementation in general practice. The current volume-based antibiotic prescription monitoring system was considered insufficient. AMS education for the public, further development of GP education, and improved consultation support were strongly recommended. The role of community-based pharmacists and nurses is largely unexplored, but their involvement was recommended. A clear leader to drive AMS in general practice is essential for an action framework to gain traction. Monitoring and feedback of antibiotic prescribing require urgent development to include monitoring of prescribing appropriateness and patient outcomes.
There is little guidance about developing systems for antimicrobial stewardship (AMS) for general practice. A literature review identified six key components: governance, monitoring of antibiotic prescribing and resistance with feedback to prescribers, consultation support, education of the public and general practitioners, pharmacist and nurse involvement, and research, which were incorporated into a potential framework for the general practice context. Objectives: to determine the feasibility and validity of the proposed AMS framework. A secondary objective was to identify likely bodies responsible for implementation in Australia. We undertook interviews with 12 key stakeholders from government, research, and professional groups. Data were analysed with a thematic approach. The framework was considered valid and feasible. No clear organisation was identified to lead AMS implementation in general practice. The current volume-based antibiotic prescription monitoring system was considered insufficient. AMS education for the public, further development of GP education, and improved consultation support were strongly recommended. The role of community-based pharmacists and nurses is largely unexplored, but their involvement was recommended. A clear leader to drive AMS in general practice is essential for an action framework to gain traction. Monitoring and feedback of antibiotic prescribing require urgent development to include monitoring of prescribing appropriateness and patient outcomes.
Entities:
Keywords:
antibiotic; antibiotics; antimicrobial stewardship; family practice; general practice; health policy; nurse; pharmacist; public health; quality of health care
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