Implementation of antimicrobial stewardship programs: A study of prescribers' perspective of facilitators and barriers.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2024
Historique:
received: 08 09 2023
accepted: 06 01 2024
medline: 19 1 2024
pubmed: 19 1 2024
entrez: 19 1 2024
Statut: epublish

Résumé

Despite promising signs of the benefits associated with Antimicrobial Stewardship Programs (ASPs), there remains limited knowledge on how to implement ASPs in peculiar settings for a more elaborate impact. This study explored prescriber experiences and perceptions of the usefulness, and feasibility of strategies employed for the implementation of antimicrobial stewardship (AMS) interventions as well as challenges encountered. This is a cross-sectional mixed-method survey of prescribers' perspective of the facilitators and barriers of implementing ASP. The quantitative approach comprised of a semi-structured questionnaire and data collected were analyzed using SPSS version 26 while the qualitative approach used focus group discussions followed by content analysis. Out of the thirty people that participated in the workshop, twenty-five completed the questionnaires which were analyzed. The respondents included 15 (60.0%) medical doctors and 10 (40.0%) pharmacists. The mean age of the respondents was 36.39±7.23 years with mean year of practice of 9.48±6.01 years. Majority of them (84.0%) were in a position to provide input on the implementation of AMS in their facilities, although their managements had the final decision. The pharmacists (100%) were more likely to agree that antibiotic resistance was a problem for their practice than the medical doctors (78.6%) while equal number (80.0%) of respondents (pharmacists and medical doctors) believed that inappropriate prescribing was a problem. Having a specialized and dedicated team with effective monitoring was recognized as crucial for effective ASP while inadequate personnel was identified as a major barrier. We identified stakeholder's engagement, policies and regulation, as well as education as themes for improving AMS in the country. The results gave insight into the prescribers' perspective on the facilitators and barriers to antimicrobial stewardship; challenges and possible solutions to implementing ASPs in health facilities in Lagos State. We further identified pertinent contextual factors that need to be addressed when developing ASPs in healthcare facilities in a resource-poor setting.

Sections du résumé

BACKGROUND BACKGROUND
Despite promising signs of the benefits associated with Antimicrobial Stewardship Programs (ASPs), there remains limited knowledge on how to implement ASPs in peculiar settings for a more elaborate impact. This study explored prescriber experiences and perceptions of the usefulness, and feasibility of strategies employed for the implementation of antimicrobial stewardship (AMS) interventions as well as challenges encountered.
METHODS METHODS
This is a cross-sectional mixed-method survey of prescribers' perspective of the facilitators and barriers of implementing ASP. The quantitative approach comprised of a semi-structured questionnaire and data collected were analyzed using SPSS version 26 while the qualitative approach used focus group discussions followed by content analysis.
RESULTS RESULTS
Out of the thirty people that participated in the workshop, twenty-five completed the questionnaires which were analyzed. The respondents included 15 (60.0%) medical doctors and 10 (40.0%) pharmacists. The mean age of the respondents was 36.39±7.23 years with mean year of practice of 9.48±6.01 years. Majority of them (84.0%) were in a position to provide input on the implementation of AMS in their facilities, although their managements had the final decision. The pharmacists (100%) were more likely to agree that antibiotic resistance was a problem for their practice than the medical doctors (78.6%) while equal number (80.0%) of respondents (pharmacists and medical doctors) believed that inappropriate prescribing was a problem. Having a specialized and dedicated team with effective monitoring was recognized as crucial for effective ASP while inadequate personnel was identified as a major barrier. We identified stakeholder's engagement, policies and regulation, as well as education as themes for improving AMS in the country.
CONCLUSION CONCLUSIONS
The results gave insight into the prescribers' perspective on the facilitators and barriers to antimicrobial stewardship; challenges and possible solutions to implementing ASPs in health facilities in Lagos State. We further identified pertinent contextual factors that need to be addressed when developing ASPs in healthcare facilities in a resource-poor setting.

Identifiants

pubmed: 38241406
doi: 10.1371/journal.pone.0297472
pii: PONE-D-23-27149
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0297472

Informations de copyright

Copyright: © 2024 Chukwu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Auteurs

Emelda E Chukwu (EE)

Antimicrobial Resistance Research group, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria.

Dennis Abuh (D)

Antimicrobial Resistance Research group, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria.

Ifeoma E Idigbe (IE)

Antimicrobial Resistance Research group, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria.

Kazeem A Osuolale (KA)

Antimicrobial Resistance Research group, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria.

Vivian Chuka-Ebene (V)

Antimicrobial Resistance Research group, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria.
Pharmacy Department, Lagos University Teaching Hospital, Lagos, Lagos State, Nigeria.

Oluwatoyin Awoderu (O)

Antimicrobial Resistance Research group, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria.

Rosemary A Audu (RA)

Antimicrobial Resistance Research group, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria.

Folasade T Ogunsola (FT)

Antimicrobial Resistance Research group, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria.
Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Lagos, Nigeria.

Classifications MeSH