Evidence-Based Strategies in Using Persuasive Interventions to Optimize Antimicrobial Use in Healthcare: a Narrative Review

Jun Rong Jeffrey Neo, Jeff Niederdeppe, Ole Vielemeyer, Brandyn Lau, Michelle Demetres, Hessam Sadatsafavi

Research output: Contribution to journalReview articlepeer-review

Abstract

A rise in antimicrobial resistance, seen especially since 2000, is in part caused by indiscriminate antimicrobial use. Varied types of persuasive interventions aimed to optimize antimicrobial use have been tried with varying success. Our review seeks to identify and assess factors associated with the successful implementation of persuasive interventions. We searched five databases (MEDLINE, EMBASE, The Cochrane Library, PsycINFO, and ERIC) to identify critical studies published between 2000 and December 2018 of interventions employing audit and feedback, education through meetings, academic detailing, reminders, and patient, family, or public education. Outcome measures of interest were any means to measure antimicrobial use. We included 26 articles in our analysis. Seventeen examined multimodal interventions and the most common was audit and feedback and meeting (four studies). Nine examined single interventions and the most common was audit and feedback (five studies). Our findings inform four evidence-based strategies to enable healthcare administrators, clinicians, and researchers to make informed choices when planning and designing an antimicrobial stewardship program: (1) implement a combination of persuasive interventions from both groups: audit and feedback, academic detailing, or patient, family, or provider education; and meeting or reminders, (2) design interventions that last one year or longer; post-intervention, assess the intervention’s long-term effects for at least another one year, (3) conduct quality improvement projects examining persuasive interventions if the prescribing database provides adequate diagnosis information, and most importantly, (4) make patient, family, or provider education an integral component of multimodal intervention.

Original languageEnglish (US)
Article number64
JournalJournal of medical systems
Volume44
Issue number3
DOIs
StatePublished - Mar 1 2020

Keywords

  • Antibiotic prescription
  • Antibiotic resistance
  • Antibiotic usage
  • Antimicrobial management
  • Antimicrobial resistance
  • Persuasive interventions

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Information Systems
  • Health Informatics
  • Health Information Management

Fingerprint

Dive into the research topics of 'Evidence-Based Strategies in Using Persuasive Interventions to Optimize Antimicrobial Use in Healthcare: a Narrative Review'. Together they form a unique fingerprint.

Cite this