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1334. A Qualitative Assessment of Drivers of Antimicrobial Prescribing for Pediatric Patients in Diverse Ambulatory Settings

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Zeitschriftentitel: Open Forum Infectious Diseases
Personen und Körperschaften: Spencer, Hillary, Katz, Sophie E, Audet, Carolyn, Banerjee, Ritu
In: Open Forum Infectious Diseases, 7, 2020, Supplement_1, S. S678-S679
Format: E-Article
Sprache: Englisch
veröffentlicht:
Oxford University Press (OUP)
Schlagwörter:
Infectious Diseases
Oncology
author_facet Spencer, Hillary
Katz, Sophie E
Audet, Carolyn
Banerjee, Ritu
Banerjee, Ritu
Spencer, Hillary
Katz, Sophie E
Audet, Carolyn
Banerjee, Ritu
Banerjee, Ritu
author Spencer, Hillary
Katz, Sophie E
Audet, Carolyn
Banerjee, Ritu
Banerjee, Ritu
spellingShingle Spencer, Hillary
Katz, Sophie E
Audet, Carolyn
Banerjee, Ritu
Banerjee, Ritu
Open Forum Infectious Diseases
1334. A Qualitative Assessment of Drivers of Antimicrobial Prescribing for Pediatric Patients in Diverse Ambulatory Settings
Infectious Diseases
Oncology
author_sort spencer, hillary
spelling Spencer, Hillary Katz, Sophie E Audet, Carolyn Banerjee, Ritu Banerjee, Ritu 2328-8957 Oxford University Press (OUP) Infectious Diseases Oncology http://dx.doi.org/10.1093/ofid/ofaa439.1516 <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Antimicrobial prescribing rates vary across ambulatory settings and provider types. We sought to identify and compare non-clinical drivers of antimicrobial prescribing for children across diverse outpatient settings.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>We recruited physicians and advanced practice providers (APPs) working in primary care, urgent care (walk-in and pediatric after-hours clinics), and retail health clinics affiliated with Vanderbilt University Medical Center (Table 1). We conducted in-person or telephone interviews using an interview guide created through an iterative process of literature review and sequential pilot testing with residents and administrators from included settings. All interviews were recorded and transcribed verbatim. Analysis is ongoing using inductive methods. The study was IRB approved with a waiver of consent.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Among the 38 providers interviewed to date, 22 (58%) were APPs. Twenty-eight (74%) interviews were conducted by telephone. In a closed-ended question, most providers (82%) identified “guideline recommended” as the primary factor informing their prescribing decisions. Providers perceived that guideline concordant care was determined by a complex interaction of patient, provider, and setting factors (Figure). A major theme identified by providers was that standardized antibiotic prescribing practices within each clinic setting and the larger community was perceived to inform parental expectations. Additionally, shaping parental expectations in a way that aligns with guidelines is a process that happens over time rather than being a one-time event. (Figure, Table 2)</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>In all outpatient settings, providers caring for children cited clinical guidelines as the most important factor influencing antibiotic prescribing. Providers felt that adherence to guidelines had downstream benefits including standardization of prescribing practices which may shape parental expectations in a way that aligns with guidelines, thus facilitating guideline-concordant care in future encounters. These findings can inform design of outpatient stewardship interventions. Additional provider recruitment and analysis by provider and setting type is ongoing.</jats:p> </jats:sec> <jats:sec> <jats:title>Disclosures</jats:title> <jats:p>Hillary Spencer, MD, MPH, NIH (T32 grant support) (Grant/Research Support)</jats:p> </jats:sec> 1334. A Qualitative Assessment of Drivers of Antimicrobial Prescribing for Pediatric Patients in Diverse Ambulatory Settings Open Forum Infectious Diseases
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title 1334. A Qualitative Assessment of Drivers of Antimicrobial Prescribing for Pediatric Patients in Diverse Ambulatory Settings
title_unstemmed 1334. A Qualitative Assessment of Drivers of Antimicrobial Prescribing for Pediatric Patients in Diverse Ambulatory Settings
title_full 1334. A Qualitative Assessment of Drivers of Antimicrobial Prescribing for Pediatric Patients in Diverse Ambulatory Settings
title_fullStr 1334. A Qualitative Assessment of Drivers of Antimicrobial Prescribing for Pediatric Patients in Diverse Ambulatory Settings
title_full_unstemmed 1334. A Qualitative Assessment of Drivers of Antimicrobial Prescribing for Pediatric Patients in Diverse Ambulatory Settings
title_short 1334. A Qualitative Assessment of Drivers of Antimicrobial Prescribing for Pediatric Patients in Diverse Ambulatory Settings
title_sort 1334. a qualitative assessment of drivers of antimicrobial prescribing for pediatric patients in diverse ambulatory settings
topic Infectious Diseases
Oncology
url http://dx.doi.org/10.1093/ofid/ofaa439.1516
publishDate 2020
physical S678-S679
description <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Antimicrobial prescribing rates vary across ambulatory settings and provider types. We sought to identify and compare non-clinical drivers of antimicrobial prescribing for children across diverse outpatient settings.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>We recruited physicians and advanced practice providers (APPs) working in primary care, urgent care (walk-in and pediatric after-hours clinics), and retail health clinics affiliated with Vanderbilt University Medical Center (Table 1). We conducted in-person or telephone interviews using an interview guide created through an iterative process of literature review and sequential pilot testing with residents and administrators from included settings. All interviews were recorded and transcribed verbatim. Analysis is ongoing using inductive methods. The study was IRB approved with a waiver of consent.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Among the 38 providers interviewed to date, 22 (58%) were APPs. Twenty-eight (74%) interviews were conducted by telephone. In a closed-ended question, most providers (82%) identified “guideline recommended” as the primary factor informing their prescribing decisions. Providers perceived that guideline concordant care was determined by a complex interaction of patient, provider, and setting factors (Figure). A major theme identified by providers was that standardized antibiotic prescribing practices within each clinic setting and the larger community was perceived to inform parental expectations. Additionally, shaping parental expectations in a way that aligns with guidelines is a process that happens over time rather than being a one-time event. (Figure, Table 2)</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>In all outpatient settings, providers caring for children cited clinical guidelines as the most important factor influencing antibiotic prescribing. Providers felt that adherence to guidelines had downstream benefits including standardization of prescribing practices which may shape parental expectations in a way that aligns with guidelines, thus facilitating guideline-concordant care in future encounters. These findings can inform design of outpatient stewardship interventions. Additional provider recruitment and analysis by provider and setting type is ongoing.</jats:p> </jats:sec> <jats:sec> <jats:title>Disclosures</jats:title> <jats:p>Hillary Spencer, MD, MPH, NIH (T32 grant support) (Grant/Research Support)</jats:p> </jats:sec>
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author Spencer, Hillary, Katz, Sophie E, Audet, Carolyn, Banerjee, Ritu, Banerjee, Ritu
author_facet Spencer, Hillary, Katz, Sophie E, Audet, Carolyn, Banerjee, Ritu, Banerjee, Ritu, Spencer, Hillary, Katz, Sophie E, Audet, Carolyn, Banerjee, Ritu, Banerjee, Ritu
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description <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Antimicrobial prescribing rates vary across ambulatory settings and provider types. We sought to identify and compare non-clinical drivers of antimicrobial prescribing for children across diverse outpatient settings.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>We recruited physicians and advanced practice providers (APPs) working in primary care, urgent care (walk-in and pediatric after-hours clinics), and retail health clinics affiliated with Vanderbilt University Medical Center (Table 1). We conducted in-person or telephone interviews using an interview guide created through an iterative process of literature review and sequential pilot testing with residents and administrators from included settings. All interviews were recorded and transcribed verbatim. Analysis is ongoing using inductive methods. The study was IRB approved with a waiver of consent.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Among the 38 providers interviewed to date, 22 (58%) were APPs. Twenty-eight (74%) interviews were conducted by telephone. In a closed-ended question, most providers (82%) identified “guideline recommended” as the primary factor informing their prescribing decisions. Providers perceived that guideline concordant care was determined by a complex interaction of patient, provider, and setting factors (Figure). A major theme identified by providers was that standardized antibiotic prescribing practices within each clinic setting and the larger community was perceived to inform parental expectations. Additionally, shaping parental expectations in a way that aligns with guidelines is a process that happens over time rather than being a one-time event. (Figure, Table 2)</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>In all outpatient settings, providers caring for children cited clinical guidelines as the most important factor influencing antibiotic prescribing. Providers felt that adherence to guidelines had downstream benefits including standardization of prescribing practices which may shape parental expectations in a way that aligns with guidelines, thus facilitating guideline-concordant care in future encounters. These findings can inform design of outpatient stewardship interventions. Additional provider recruitment and analysis by provider and setting type is ongoing.</jats:p> </jats:sec> <jats:sec> <jats:title>Disclosures</jats:title> <jats:p>Hillary Spencer, MD, MPH, NIH (T32 grant support) (Grant/Research Support)</jats:p> </jats:sec>
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spelling Spencer, Hillary Katz, Sophie E Audet, Carolyn Banerjee, Ritu Banerjee, Ritu 2328-8957 Oxford University Press (OUP) Infectious Diseases Oncology http://dx.doi.org/10.1093/ofid/ofaa439.1516 <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Antimicrobial prescribing rates vary across ambulatory settings and provider types. We sought to identify and compare non-clinical drivers of antimicrobial prescribing for children across diverse outpatient settings.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>We recruited physicians and advanced practice providers (APPs) working in primary care, urgent care (walk-in and pediatric after-hours clinics), and retail health clinics affiliated with Vanderbilt University Medical Center (Table 1). We conducted in-person or telephone interviews using an interview guide created through an iterative process of literature review and sequential pilot testing with residents and administrators from included settings. All interviews were recorded and transcribed verbatim. Analysis is ongoing using inductive methods. The study was IRB approved with a waiver of consent.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Among the 38 providers interviewed to date, 22 (58%) were APPs. Twenty-eight (74%) interviews were conducted by telephone. In a closed-ended question, most providers (82%) identified “guideline recommended” as the primary factor informing their prescribing decisions. Providers perceived that guideline concordant care was determined by a complex interaction of patient, provider, and setting factors (Figure). A major theme identified by providers was that standardized antibiotic prescribing practices within each clinic setting and the larger community was perceived to inform parental expectations. Additionally, shaping parental expectations in a way that aligns with guidelines is a process that happens over time rather than being a one-time event. (Figure, Table 2)</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>In all outpatient settings, providers caring for children cited clinical guidelines as the most important factor influencing antibiotic prescribing. Providers felt that adherence to guidelines had downstream benefits including standardization of prescribing practices which may shape parental expectations in a way that aligns with guidelines, thus facilitating guideline-concordant care in future encounters. These findings can inform design of outpatient stewardship interventions. Additional provider recruitment and analysis by provider and setting type is ongoing.</jats:p> </jats:sec> <jats:sec> <jats:title>Disclosures</jats:title> <jats:p>Hillary Spencer, MD, MPH, NIH (T32 grant support) (Grant/Research Support)</jats:p> </jats:sec> 1334. A Qualitative Assessment of Drivers of Antimicrobial Prescribing for Pediatric Patients in Diverse Ambulatory Settings Open Forum Infectious Diseases
spellingShingle Spencer, Hillary, Katz, Sophie E, Audet, Carolyn, Banerjee, Ritu, Banerjee, Ritu, Open Forum Infectious Diseases, 1334. A Qualitative Assessment of Drivers of Antimicrobial Prescribing for Pediatric Patients in Diverse Ambulatory Settings, Infectious Diseases, Oncology
title 1334. A Qualitative Assessment of Drivers of Antimicrobial Prescribing for Pediatric Patients in Diverse Ambulatory Settings
title_full 1334. A Qualitative Assessment of Drivers of Antimicrobial Prescribing for Pediatric Patients in Diverse Ambulatory Settings
title_fullStr 1334. A Qualitative Assessment of Drivers of Antimicrobial Prescribing for Pediatric Patients in Diverse Ambulatory Settings
title_full_unstemmed 1334. A Qualitative Assessment of Drivers of Antimicrobial Prescribing for Pediatric Patients in Diverse Ambulatory Settings
title_short 1334. A Qualitative Assessment of Drivers of Antimicrobial Prescribing for Pediatric Patients in Diverse Ambulatory Settings
title_sort 1334. a qualitative assessment of drivers of antimicrobial prescribing for pediatric patients in diverse ambulatory settings
title_unstemmed 1334. A Qualitative Assessment of Drivers of Antimicrobial Prescribing for Pediatric Patients in Diverse Ambulatory Settings
topic Infectious Diseases, Oncology
url http://dx.doi.org/10.1093/ofid/ofaa439.1516