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Intervention planning for ARK (Antibiotic Review Kit): a digital and behavioural intervention to safely review and reduce antibiotic prescriptions in acute and general medicine

Intervention planning for ARK (Antibiotic Review Kit): a digital and behavioural intervention to safely review and reduce antibiotic prescriptions in acute and general medicine
Intervention planning for ARK (Antibiotic Review Kit): a digital and behavioural intervention to safely review and reduce antibiotic prescriptions in acute and general medicine
Background: hospital antimicrobial stewardship strategies, such as “Start Smart, then Focus” in the UK, balance the need for prompt, effective antibiotic treatment with the need to limit antibiotic overuse using “review and revise”. However only a minority of review decisions are to stop antibiotics. Research suggests that this is due to both behavioural and organisational factors.

Objectives: to develop and optimise the ARK (Antibiotic Review Kit) intervention. ARK is a complex digital, organisational and behavioural intervention that supports implementation of “review and revise” to help healthcare professionals safely stop unnecessary antibiotics.

Methods: a theory-, evidence- and person-based approach was used to develop and optimise ARK and its implementation. This was done through iterative stakeholder consultation and in-depth qualitative research with doctors, nurses, and pharmacists in UK hospitals. Barriers and facilitators to the intervention and its implementation, and ways to address them, were identified and then used to inform the intervention’s development.

Results: a key barrier to stopping antibiotics was reportedly a lack of information about the original prescriber’s rationale for and their degree of certainty about the need for antibiotics. An integral component of ARK was the development and optimisation of a Decision Aid and its implementation to increase transparency around initial prescribing decisions.

Conclusions: the key output of this research is a digital and behavioural intervention targeting important barriers to stopping antibiotics at review. ARK will be evaluated in a feasibility study and, if successful, a stepped-wedge cluster-randomised controlled trial at acute hospitals across the National Health Service.
0305-7453
Santillo, Marta
ea247305-2516-4c12-9c07-bf33cf659038
Sivyer, Katy
c9831d57-7d6b-4bb6-bb3c-770ea7f9b116
Krusche, Adele
336ef9cd-ec58-4826-8eaa-9c9f6edbb0ee
Mowbray, Fiona
0a9e37a7-06c7-4926-95cb-af2d1eb22157
Jones, Nicola
29c919bc-ee6e-4ec9-a23d-913318d7ca44
Peto, Tim
dd1c6791-fff1-4c4f-af11-bfe35e01b959
Walker, Sarah
b586dd08-93f5-4f5a-b79c-7c01e9b03d91
Llewelyn, Martin
63b583ab-69de-4bd0-b0a7-051f16e69542
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Santillo, Marta
ea247305-2516-4c12-9c07-bf33cf659038
Sivyer, Katy
c9831d57-7d6b-4bb6-bb3c-770ea7f9b116
Krusche, Adele
336ef9cd-ec58-4826-8eaa-9c9f6edbb0ee
Mowbray, Fiona
0a9e37a7-06c7-4926-95cb-af2d1eb22157
Jones, Nicola
29c919bc-ee6e-4ec9-a23d-913318d7ca44
Peto, Tim
dd1c6791-fff1-4c4f-af11-bfe35e01b959
Walker, Sarah
b586dd08-93f5-4f5a-b79c-7c01e9b03d91
Llewelyn, Martin
63b583ab-69de-4bd0-b0a7-051f16e69542
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e

Santillo, Marta, Sivyer, Katy, Krusche, Adele, Mowbray, Fiona, Jones, Nicola, Peto, Tim, Walker, Sarah, Llewelyn, Martin and Yardley, Lucy (2019) Intervention planning for ARK (Antibiotic Review Kit): a digital and behavioural intervention to safely review and reduce antibiotic prescriptions in acute and general medicine. Journal of Antimicrobial Chemotherapy. (In Press)

Record type: Article

Abstract

Background: hospital antimicrobial stewardship strategies, such as “Start Smart, then Focus” in the UK, balance the need for prompt, effective antibiotic treatment with the need to limit antibiotic overuse using “review and revise”. However only a minority of review decisions are to stop antibiotics. Research suggests that this is due to both behavioural and organisational factors.

Objectives: to develop and optimise the ARK (Antibiotic Review Kit) intervention. ARK is a complex digital, organisational and behavioural intervention that supports implementation of “review and revise” to help healthcare professionals safely stop unnecessary antibiotics.

Methods: a theory-, evidence- and person-based approach was used to develop and optimise ARK and its implementation. This was done through iterative stakeholder consultation and in-depth qualitative research with doctors, nurses, and pharmacists in UK hospitals. Barriers and facilitators to the intervention and its implementation, and ways to address them, were identified and then used to inform the intervention’s development.

Results: a key barrier to stopping antibiotics was reportedly a lack of information about the original prescriber’s rationale for and their degree of certainty about the need for antibiotics. An integral component of ARK was the development and optimisation of a Decision Aid and its implementation to increase transparency around initial prescribing decisions.

Conclusions: the key output of this research is a digital and behavioural intervention targeting important barriers to stopping antibiotics at review. ARK will be evaluated in a feasibility study and, if successful, a stepped-wedge cluster-randomised controlled trial at acute hospitals across the National Health Service.

Text
ARK_intervention_planning_manuscript_accepted_clean - Accepted Manuscript
Restricted to Repository staff only until 7 July 2020.
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Accepted/In Press date: 7 July 2019

Identifiers

Local EPrints ID: 432901
URI: https://eprints.soton.ac.uk/id/eprint/432901
ISSN: 0305-7453
PURE UUID: 807d1cad-fcde-4c99-9caa-a8619e1a2554
ORCID for Katy Sivyer: ORCID iD orcid.org/0000-0003-4349-0102
ORCID for Fiona Mowbray: ORCID iD orcid.org/0000-0002-3297-4163
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X

Catalogue record

Date deposited: 31 Jul 2019 16:30
Last modified: 01 Aug 2019 00:37

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Contributors

Author: Marta Santillo
Author: Katy Sivyer ORCID iD
Author: Adele Krusche
Author: Fiona Mowbray ORCID iD
Author: Nicola Jones
Author: Tim Peto
Author: Sarah Walker
Author: Martin Llewelyn
Author: Lucy Yardley ORCID iD

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