Self-Reported Antimicrobial Stewardship Practices in Primary Care Using the TARGET Antibiotics Self-Assessment Tool.

The self-assessment tool (SAT) is a 16-question self-report of antimicrobial stewardship practices in primary care, available in the TARGET (Treat Antibiotics Responsibly, Guidance Education and Tools) Antibiotics Toolkit. This study analysed responses to the SAT and compared them to previous SAT data (2014-2016). Data from June 2016 to September 2019 were anonymised and analysed using Microsoft Excel and STATA 15. Clinicians reported engaging in positive antimicrobial stewardship (AMS) practices including using antibiotic guidance to inform treatment decisions (98%, 98% 2014-2016), discussing antibiotic prescribing within the practice (73%, 67% 2014-2016), using patient-facing resources (94%, 71% 2014-2016), conducting antibiotic audits in the last two years (98%, 45% 2014-2016), keeping written records and action plans (81%, 62% 2014-2016), using back-up prescribing (99%, 94% 2014-2016) and using clinical coding (80%, 75% 2014-2016). Areas for improvement include developing strategies to avoid patients reconsulting to obtain antibiotics (45%, 33% 2014-2016), undertaking infection-related learning (37%, 29% 2014-2016), ensuring all temporary prescribers have access to antibiotic guidance (55%, 63% 2014-2016) and making patient information leaflets easily available during consultations (31%). The findings offer a unique insight into AMS in primary care over time. The SAT gives primary care clinicians and commissioners an opportunity to reflect on their AMS and learning.

Self-Assessment of Antimicrobial Stewardship in Primary Care: Self-Reported Practice Using the TARGET Primary Care Self-Assessment Tool.

Multifaceted antimicrobial stewardship (AMS) interventions including: antibiotic guidance, reviews of antibiotic use using audits, education, patient facing materials, and self-assessment, are successful in improving antimicrobial use. We aimed to measure the self-reported AMS activity of staff completing a self-assessment tool (SAT). The Royal College of General Practitioners (RCGP)/Public Health England (PHE) SAT enables participants considering an AMS eLearning course to answer 12 short questions about their AMS activities. Questions cover guidance, audit, and reflection about antibiotic use, patient facing materials, and education. Responses are recorded digitally. Data were collated, anonymised, and exported into Microsoft Excel. Between November 2014 and June 2016, 1415 users completed the SAT. Ninety eight percent reported that they used antibiotic guidance for treating common infections and 63% knew this was available to all prescribers. Ninety four percent of GP respondents reported having used delayed prescribing when appropriate, 25% were not using Read codes, and 62% reported undertaking a practice-wide antibiotic audit in the last two years, of which, 77% developed an audit action plan. Twenty nine percent had undertaken other antibiotic-related clinical courses. Fifty six percent reported sharing patient leaflets covering infection. Many prescribers reported undertaking a range of AMS activities. GP practice managers should ensure that all clinicians have access to prescribing guidance. Antibiotic audits should be encouraged to enable GP staff to understand their prescribing behaviour and address gaps in good practice. Prescribers are not making full use of antibiotic prescribing-related training opportunities. Read coding facilitates more accurate auditing and its use by all clinicians should be encouraged.