Perception of antimicrobial stewardship interventions in Swiss primary care: a mixed-methods survey

• DOI: 10.3399/bjgpo.2024.0110
• Publication Date: 2024-12-09T10:30:53Z
• Authors: Simeon Schaad; Jelena Dunaiceva; Arnaud Peytremann; Sophie Gendolla; Lauren Clack; Catherine Plüss-S...; Anne Niquille; Anna Nicolet; Joachim Marti; Noémie Boillat-Bl...; Aline Wolfensberger; Yolanda Mueller
• Keywords: primary care; 03 medical and health sciences; 0302 clinical medicine; feasibility.; acceptability; 11549 Institute of Implementation Science in Health Care; 610 Medicine & health; Antimicrobial stewardship; implementation; appropriateness

BackgroundWith most of the antibiotic prescriptions occurring in primary care, antimicrobial stewardship (AMS) interventions must be known, welcomed, and used by primary care physicians (PCPs).AimThe main objective of this study was to evaluate the present awareness about, use of, and perceived acceptability, appropriateness, and feasibility of a broad range of interventions.Design & settingA cross-sectional survey was distributed to Swiss PCPs from December 2023 to February 2024.MethodThe survey focused on eight AMS interventions: shared decision-making tools, factsheets for physicians, Swiss Federal Office of Public Health (FOPH) information material, national antibiotic guidelines website, audit and feedback, communication skills training, as well as the use of point-of-care C-reactive protein (POC-CRP) and procalcitonin (POC-PCT) to guide prescription. PCPs’ perceived acceptability, appropriateness, and feasibility were assessed using five-point Likert scales. General expectations regarding AMS were evaluated via qualitative analysis of free-text answers.ResultsOut of 7456 potentially eligible primary care physicians, 355 PCPs answered at least one question (response rate 4.7%). PCPs were most aware of biomarkers to guide antibiotic prescription in RTIs, such as POC-PCT (67.6%) and POC-CRP (61.1%), the FOPH awareness campaign (57.3%) and the national guidelines website (52.7%). All interventions were rated as acceptable, appropriate, and feasible, with respective mean scores out of five of 3.89, 3.91, and 3.81.ConclusionDespite the high perceived acceptability, appropriateness, and feasibility of AMS interventions available for RTIs, their real-life impact may be hindered by insufficient awareness. Additional promotion of those tools could increase their uptake by physicians.