Evaluation of a Virtual Antimicrobial Stewardship Team (VAT) on Antibiotic Prescriptions From Clinicians in Nursing Homes: A Multicenter Randomised Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 57
- 试验地点
- 2
- 主要终点
- Inappropriate antibiotic prescriptions
研究概览
简要总结
The Virtual Antimicrobial stewardship Team (VAT) study aims to evaluate, in a randomized controlled trial (RCT), the effect of a weekly virtual antimicrobial stewardship (AMS) intervention on the appropriateness of prescribing antibiotics for nursing home (NH) residents with urinary tract infections (UTI), respiratory tract infections (RTI) or skin and soft tissue infections (SSTI) compared to standard care for NH residents in Dutch NHs in the provinces of North-Holland and Flevoland. The secondary aim is to identify barriers and facilitators to implement a stewardship intervention and subsequently develop an implementation guide.
详细描述
Rationale: Antimicrobial stewardship interventions have been extensively studied in hospital settings and have proven effective in reducing the number of infections with multidrug resistant micro-organisms and are also cost-effective. Therefore, AMS teams are mandatory in Dutch hospitals.
The effectiveness of an antimicrobial stewardship intervention is variable in previous studies. Also due to the perceived high workload and costs, AMS has hardly been implemented in Dutch NHs. In order to take the next step towards implementation of AMS in NHs, causality between AMS and reduction in inappropriate antibiotic prescriptions should be demonstrated. The investigators want to evaluate the process and value of the VAT approach to facilitate optimal implementation of VAT in other NHs.
Objective: To demonstrate the efficacy of weekly virtual antimicrobial stewardship team meetings in reducing inappropriate antibiotic prescriptions in Dutch NHs.
Study design: randomized, non-blinded, controlled, multicenter trial.
Study population: Clinicians working in NHs in the provinces North Holland and Flevoland.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •of clinicians:
- •Working in nursing homes in the North Holland-Flevoland region and being authorized to prescribe.
- •Agreeing to being randomized to intervention or control group.
- •Working in a nursing home that has a medication prescription system from which prescriptions can easily be obtained for VAT meetings.
- •Working in a nursing home that is connected to a microbiology lab, .that participates in this study and offers VAT meetings.
- •Expected to be employed for at least four months from date of randomization.
- •Inclusion Criteria of antibiotic prescriptions:
- •All prescriptions for antibiotics with a therapeutic indication regarding urinary tract infections, respiratory tract infections or skin and soft tissue infections for residents of nursing homes, prescribed by clinicians participating in the study, during the study period.
排除标准
- •of antibiotic prescriptions:
- •Prescriptions for antibiotics with a prophylactic purpose.
- •Prescriptions given by clinicians not participating in the study
- •Prescriptions prescribed outside the study period.
结局指标
主要结局
Inappropriate antibiotic prescriptions
时间窗: 9 months
The proportion of inappropriate antibiotic prescriptions in the intervention group compared to the control group (standard of care) according to the current guidelines algorithm.
次要结局
- Incidence rate (IR)(9 months)
- Barriers and facilitators(9 months)
研究者
Maarten Schim van der Loeff
Professor
Public Health Service of Amsterdam