Optimal Implementation of Antimicrobial Stewardship in General Practice: protocol for a feasibility study and evaluation of a digital AMS Toolbox

Abstract Background Antimicrobial resistance is a worldwide problem caused by the inappropriate use of antibiotics. In Australia, antibiotics are frequently prescribed in general practice (primary care) settings for acute respiratory infections (ARIs) despite these infections most commonly being cau...

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Main Authors: Colin H. Cortie, Mary A. Burns, Margaret Jordan, Judy Mullan, Grant M. Russell, Nicholas Zwar, Danielle Mazza, Jan Radford, Gregory M. Peterson, Indra Gajanayake, Simon Eckermann, Stephen Barnett, Caitlin Keighley, Katherine Michelmore, Christine Metusela, Fiona Williams, Marijka J. Batterham, Andrew Bonney
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Pilot and Feasibility Studies
Online Access:https://doi.org/10.1186/s40814-025-01686-6
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author Colin H. Cortie
Mary A. Burns
Margaret Jordan
Judy Mullan
Grant M. Russell
Nicholas Zwar
Danielle Mazza
Jan Radford
Gregory M. Peterson
Indra Gajanayake
Simon Eckermann
Stephen Barnett
Caitlin Keighley
Katherine Michelmore
Christine Metusela
Fiona Williams
Marijka J. Batterham
Andrew Bonney
author_facet Colin H. Cortie
Mary A. Burns
Margaret Jordan
Judy Mullan
Grant M. Russell
Nicholas Zwar
Danielle Mazza
Jan Radford
Gregory M. Peterson
Indra Gajanayake
Simon Eckermann
Stephen Barnett
Caitlin Keighley
Katherine Michelmore
Christine Metusela
Fiona Williams
Marijka J. Batterham
Andrew Bonney
author_sort Colin H. Cortie
collection DOAJ
description Abstract Background Antimicrobial resistance is a worldwide problem caused by the inappropriate use of antibiotics. In Australia, antibiotics are frequently prescribed in general practice (primary care) settings for acute respiratory infections (ARIs) despite these infections most commonly being caused by viruses. The Optimal Implementation of Antimicrobial Stewardship in General Practice (OptimasGP) study aims to provide implementation support for effective antimicrobial stewardship (AMS) interventions for ARIs. The current study will examine if a redesigned workflow, and an AMS Toolbox containing AMS resources, is an acceptable way to access AMS interventions and clinical data collected in general practice settings. Methods A mixed-methods approach will be applied using a single-arm, pragmatic exploratory study. Data will be collected for a period of 3 months. Data collection from general practice settings in New South Wales, Australia, will involve the participation of 4 to 6 practices, 12 general practitioners (GPs), and 6 to 8 practice staff. We also aim to recruit 50–100 patients to complete surveys and 12 patients to participate in focus group discussions. Participating GPs and practice staff will be provided with an online AMS Toolbox to facilitate access to AMS resources. Two hours of online training and a reminder card will also be provided. The AMS Toolbox will contain AMS resources for shared decision-making, clinical decision support (including point-of-care testing), and delayed antibiotic prescribing in patients with ARIs. The primary outcome of the study will be the acceptability of the AMS Toolbox to GPs, practice staff, and patients. Secondary outcomes will include recruitment and completion rates, qualitative findings from the focus group discussions, resource use and antibiotic prescription rates, patient-reported outcome measures (PROMs), and patient-reported experience measures (PREMS). Discussion AMS interventions are needed to help reduce inappropriate antibiotic prescribing for ARIs in general practice settings. The findings of this study will inform a hybrid type 3 implementation trial. Trial registration Registered prospectively with the Australian and New Zealand Clinical Trial Registry (ACTRN12624001011572) on 20 August 2024.
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spelling doaj-art-d68d465ddbdd483fa49748c17a676ec72025-08-20T03:04:22ZengBMCPilot and Feasibility Studies2055-57842025-07-0111111110.1186/s40814-025-01686-6Optimal Implementation of Antimicrobial Stewardship in General Practice: protocol for a feasibility study and evaluation of a digital AMS ToolboxColin H. Cortie0Mary A. Burns1Margaret Jordan2Judy Mullan3Grant M. Russell4Nicholas Zwar5Danielle Mazza6Jan Radford7Gregory M. Peterson8Indra Gajanayake9Simon Eckermann10Stephen Barnett11Caitlin Keighley12Katherine Michelmore13Christine Metusela14Fiona Williams15Marijka J. Batterham16Andrew Bonney17Graduate School of Medicine, Faculty of Science, Medicine and Health, University of WollongongGraduate School of Medicine, Faculty of Science, Medicine and Health, University of WollongongGraduate School of Medicine, Faculty of Science, Medicine and Health, University of WollongongGraduate School of Medicine, Faculty of Science, Medicine and Health, University of WollongongNursing and Health Sciences, School of Public Health and Preventive Medicine, Faculty of Medicine, Monash UniversityFaculty of Health Sciences and Medicine, Bond UniversityNursing and Health Sciences, School of Public Health and Preventive Medicine, Faculty of Medicine, Monash UniversitySchool of Medicine, College of Health and Medicine, University of TasmaniaSchool of Pharmacy and Pharmacology, College of Health and Medicine, University of TasmaniaUniversity of WollongongSchool of Social Sciences, Faculty of the Arts, Social Sciences and Humanities, University of WollongongGraduate School of Medicine, Faculty of Science, Medicine and Health, University of WollongongGraduate School of Medicine, Faculty of Science, Medicine and Health, University of WollongongInnovation Campus, COORDINAREGraduate School of Medicine, Faculty of Science, Medicine and Health, University of WollongongGraduate School of Medicine, Faculty of Science, Medicine and Health, University of WollongongStatistical Consulting Centre, Faculty of Engineering and Information Sciences, School of Mathematics and Applied Statistics, University of WollongongGraduate School of Medicine, Faculty of Science, Medicine and Health, University of WollongongAbstract Background Antimicrobial resistance is a worldwide problem caused by the inappropriate use of antibiotics. In Australia, antibiotics are frequently prescribed in general practice (primary care) settings for acute respiratory infections (ARIs) despite these infections most commonly being caused by viruses. The Optimal Implementation of Antimicrobial Stewardship in General Practice (OptimasGP) study aims to provide implementation support for effective antimicrobial stewardship (AMS) interventions for ARIs. The current study will examine if a redesigned workflow, and an AMS Toolbox containing AMS resources, is an acceptable way to access AMS interventions and clinical data collected in general practice settings. Methods A mixed-methods approach will be applied using a single-arm, pragmatic exploratory study. Data will be collected for a period of 3 months. Data collection from general practice settings in New South Wales, Australia, will involve the participation of 4 to 6 practices, 12 general practitioners (GPs), and 6 to 8 practice staff. We also aim to recruit 50–100 patients to complete surveys and 12 patients to participate in focus group discussions. Participating GPs and practice staff will be provided with an online AMS Toolbox to facilitate access to AMS resources. Two hours of online training and a reminder card will also be provided. The AMS Toolbox will contain AMS resources for shared decision-making, clinical decision support (including point-of-care testing), and delayed antibiotic prescribing in patients with ARIs. The primary outcome of the study will be the acceptability of the AMS Toolbox to GPs, practice staff, and patients. Secondary outcomes will include recruitment and completion rates, qualitative findings from the focus group discussions, resource use and antibiotic prescription rates, patient-reported outcome measures (PROMs), and patient-reported experience measures (PREMS). Discussion AMS interventions are needed to help reduce inappropriate antibiotic prescribing for ARIs in general practice settings. The findings of this study will inform a hybrid type 3 implementation trial. Trial registration Registered prospectively with the Australian and New Zealand Clinical Trial Registry (ACTRN12624001011572) on 20 August 2024.https://doi.org/10.1186/s40814-025-01686-6
spellingShingle Colin H. Cortie
Mary A. Burns
Margaret Jordan
Judy Mullan
Grant M. Russell
Nicholas Zwar
Danielle Mazza
Jan Radford
Gregory M. Peterson
Indra Gajanayake
Simon Eckermann
Stephen Barnett
Caitlin Keighley
Katherine Michelmore
Christine Metusela
Fiona Williams
Marijka J. Batterham
Andrew Bonney
Optimal Implementation of Antimicrobial Stewardship in General Practice: protocol for a feasibility study and evaluation of a digital AMS Toolbox
Pilot and Feasibility Studies
title Optimal Implementation of Antimicrobial Stewardship in General Practice: protocol for a feasibility study and evaluation of a digital AMS Toolbox
title_full Optimal Implementation of Antimicrobial Stewardship in General Practice: protocol for a feasibility study and evaluation of a digital AMS Toolbox
title_fullStr Optimal Implementation of Antimicrobial Stewardship in General Practice: protocol for a feasibility study and evaluation of a digital AMS Toolbox
title_full_unstemmed Optimal Implementation of Antimicrobial Stewardship in General Practice: protocol for a feasibility study and evaluation of a digital AMS Toolbox
title_short Optimal Implementation of Antimicrobial Stewardship in General Practice: protocol for a feasibility study and evaluation of a digital AMS Toolbox
title_sort optimal implementation of antimicrobial stewardship in general practice protocol for a feasibility study and evaluation of a digital ams toolbox
url https://doi.org/10.1186/s40814-025-01686-6
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