A complex ePrescribing-based Anti-Microbial Stewardship (ePAMS+) intervention for hospitals combining technological and behavioural components: protocol for a feasibility trial

• DOI: 10.1186/s40814-022-01230-w
• Publication Date: 2023-01-28T07:05:36Z
• Authors: Christopher J. Weir; Imad Adamestam; Rona Sharp; Holly Ennis; Andrew Heed; Robin Williams; Kathrin Cresswell; Omara Dogar; Sarah Pontefract; Jamie Coleman; Richard Lilford; Neil Watson; Ann Slee; Antony Chuter; Jillian Beggs; Sarah Slight; James Mason; Lucy Yardley; Aziz Sheikh
• Keywords: Antimicrobial Stewardship; Stewardship; Qualitative property; Guideline

Abstract Background Antimicrobial resistance is a leading global public health threat, with inappropriate use of antimicrobials in healthcare contributing to its development. Given this urgent need, we developed complex ePrescribing-based Anti-Microbial Stewardship intervention (ePAMS+). Methods ePAMS+ includes educational and organisational behavioural elements, plus guideline-based clinical decision support aid optimal antimicrobial hospital inpatients. particularly focuses on prompt initiation antimicrobials, followed by early review once test results are available facilitate informed decision-making stopping or switching where appropriate. A mixed-methods feasibility trial will take place two NHS acute care organisations. Qualitative staff interviews observation practice respectively gather views the technical component information their routine work. Focus groups elicit patient ePAMS+; one-to-one discuss stewardship record experiences receiving antibiotics thoughts prescribing. data be analysed thematically. Fidelity Index development enable enactment measured objectively subsequent assessing effectiveness ePAMS+. Quantitative collection determine extracting deriving key summaries prescribing; quantify variability primary outcome, number antibiotic defined daily doses, inform future larger-scale design. Discussion This essential implementing measuring relevant outcomes, prior evaluating cost-effectiveness full scale hybrid cluster-randomised stepped-wedge trial. Findings shared study sites qualitative research participants published peer-reviewed journals presented at academic conferences. Trial registration The were approved Health Research Authority North Scotland Ethics Service (ref: 19/NS/0174). quantitative analysis (protocol v1.0, 15 December 2021) London South East Committee 22/LO/0204) registered ISRCTN ( 13429325 ) 24 March 2022