Shared decision support for patients. An antimicrobial stewardship strategy to promote appropriate antibiotics use in primary care

Conference:

SAPC ASM 2022 - UCLan

Talk Code:

1P.1

Presenter:

Ruby Biezen

Co-authors:

Dr Ruby Biezen1, A/Prof Jo-Anne Manski-Nankervis1, Ms Kaleswari Somasundaram1, Prof Kirsty Buising2,3

Author institutions:

Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia. National Centre for Antimicrobial Stewardship, The University of Melbourne, Melbourne, Victoria, Australia. Victorian Infectious Diseases Service, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.

Problem:

Judicious use of antibiotics can limit the emergence of antibiotic resistance in pathogens and help to reduce adverse drug events. This is especially important if they are being prescribed for people unlikely to benefit from them. Providing patients with information about non-antibiotic management strategies, and when to consider antibiotics is important. Decision making can be supported using tools to guide discussion and promote a shared understanding between health professionals and patients. In October 2019-March 2020, we co-designed seven patient information sheets for common infections to support antimicrobial stewardship in primary care (addressing acute bronchitis, middle ear infection, nose & sinus infection, sore throat, urinary tract infection, cellulitis and leg ulcers). The aim of this study was to pilot the use of these information sheets for their acceptability and feasibility in general practice.

Approach:

Four rural and four metropolitan general practices participated in the pilot study between August-November 2020. Participating general practitioners (GPs) used the information sheets with their patients where they deemed appropriate. Semi-structured interviews were conducted with GPs, practice nurse (PN) and patients to explore acceptability and usability of the information sheets. Data were analysed thematically.

Findings:

14 GPs, one PN and 13 patients participated in the interviews. Participants found the information sheets well designed, visually appealing and easy to understand. Patients reported the sheets provided useful information and improved patients’ knowledge about antibiotics and infection management. While these tools may not be used with every patient, GPs commented that the information sheets complemented their consultations with an opportunity to provide something to patients rather than an antibiotic script. Although reasons behind using these information sheets were different for participants, they agreed that the content was relevant, and improved patient knowledge of disease conditions, treatment and management options, including when to see a doctor.

Implications:

The tools provided evidence-based information that was useful for healthcare providers and patients as part of consultations. These may be important resources for peak bodies to consider endorsing, providing, and maintaining in future. The suite might also be expanded to include new conditions.