First name
Sara
Middle name
C
Last name
Keller

Title

Antibiotic stewardship in direct-to-consumer telemedicine: translating interventions into the virtual realm.

Year of Publication

2021

Date Published

2021 Oct 07

ISSN Number

1460-2091

Abstract

<p>Direct-to-consumer (DTC) telemedicine is an increasingly popular modality for delivery of medical care via a virtual platform. As most DTC telemedicine visits focus on infection-related complaints, there is growing concern about the magnitude of antibiotic use associated with this setting. However, there is limited scholarship regarding adapting and implementing antibiotic stewardship principles in this setting as most efforts have been focused on hospitals with more recent work in long-term care facilities and primary care settings. We discuss utilizing the core elements for outpatient antibiotic stewardship as a framework for DTC antibiotic stewardship efforts moving forward.</p>

DOI

10.1093/jac/dkab371

Alternate Title

J Antimicrob Chemother

PMID

34618026

Title

"I Never Get Better Without an Antibiotic": Antibiotic Appeals and How to Respond.

Year of Publication

2021

Number of Pages

543-546

Date Published

2021 03

ISSN Number

1942-5546

DOI

10.1016/j.mayocp.2020.09.031

Alternate Title

Mayo Clin Proc

PMID

33673907

Title

COVID-19 Research Agenda for Healthcare Epidemiology.

Year of Publication

2021

Number of Pages

1-81

Date Published

2021 Jan 25

ISSN Number

1559-6834

Abstract

<p>This SHEA white paper identifies knowledge gaps and challenges in healthcare epidemiology research related to COVID-19 with a focus on core principles of healthcare epidemiology. These gaps, revealed during the worst phases of the COVID-19 pandemic, are described in 10 sections: epidemiology, outbreak investigation, surveillance, isolation precaution practices, personal protective equipment (PPE), environmental contamination and disinfection, drug and supply shortages, antimicrobial stewardship, healthcare personnel (HCP) occupational safety, and return to work policies. Each section highlights three critical healthcare epidemiology research questions with detailed description provided in supplemental materials. This research agenda calls for translational studies from laboratory-based basic science research to well-designed, large-scale studies and health outcomes research. Research gaps and challenges related to nursing homes and social disparities are included. Collaborations across various disciplines, expertise and across diverse geographic locations will be critical.</p>

DOI

10.1017/ice.2021.25

Alternate Title

Infect Control Hosp Epidemiol

PMID

33487199

Title

The inconvincible patient: how clinicians perceive demand for antibiotics in the outpatient setting.

Year of Publication

2019

Date Published

2019 Nov 06

ISSN Number

1460-2229

Abstract

<p><strong>BACKGROUND: </strong>Perceived patient demand for antibiotics drives unnecessary antibiotic prescribing in outpatient settings, but little is known about how clinicians experience this demand or how this perceived demand shapes their decision-making.</p>

<p><strong>OBJECTIVE: </strong>To identify how clinicians perceive patient demand for antibiotics and the way these perceptions stimulate unnecessary prescribing.</p>

<p><strong>METHODS: </strong>Qualitative study using semi-structured interviews with clinicians in outpatient settings who prescribe antibiotics. Interviews were analyzed using conventional and directed content analysis.</p>

<p><strong>RESULTS: </strong>Interviews were conducted with 25 clinicians from nine practices across three states. Patient demand was the most common reason respondents provided for why they prescribed non-indicated antibiotics. Three related factors motivated clinically unnecessary antibiotic use in the face of perceived patient demand: (i) clinicians want their patients to regard clinical visits as valuable and believe that an antibiotic prescription demonstrates value; (ii) clinicians want to avoid negative repercussions of denying antibiotics, including reduced income, damage to their reputation, emotional exhaustion, and degraded relationships with patients; (iii) clinicians believed that certain patients are impossible to satisfy without an antibiotic prescription and felt that efforts to refuse antibiotics to such patients wastes time and invites the aforementioned negative repercussions. Clinicians in urgent care settings were especially likely to describe being motivated by these factors.</p>

<p><strong>CONCLUSION: </strong>Interventions to improve antibiotic use in the outpatient setting must address clinicians' concerns about providing value for their patients, fear of negative repercussions from denying antibiotics, and the approach to inconvincible patients.</p>

DOI

10.1093/fampra/cmz066

Alternate Title

Fam Pract

PMID

31690948

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