Antimicrobial stewardship in Australia: the role of qualitative research in programme development

Karin A Thursky; Laura Y Hardefeldt; Arjun Rajkhowa; Courtney Ierano; Jaclyn Bishop; Lesley Hawes; Ruby Biezen; Sajal K Saha; Leslie Dowson; Kirsten E Bailey; Ri Scarborough; Stephen B Little; Fiona Gotterson; Brian Hur; Anna Khanina; Karen Urbancic; Helen K Crabb; Suzanna Richards; Anna Sri; Rodney James; David C M Kong; Caroline Marshall; Danielle Mazza; Trisha Peel; Rhonda L Stuart; Jo-Anne Manski-Nankervis; N Deborah Friedman; Noleen Bennett; Thomas Schulz; Helen Billman-Jacobe; Evette Buono; Leon Worth; Ann Bull; Michael Richards; Darshini Ayton; James R Gilkerson; Glenn F Browning; Kirsty L Buising; National Centre for Antimicrobial Stewardship

doi:10.1093/jacamr/dlab166

Antimicrobial stewardship in Australia: the role of qualitative research in programme development

JAC Antimicrob Resist. 2021 Nov 18;3(4):dlab166. doi: 10.1093/jacamr/dlab166. eCollection 2021 Dec.

Authors

Karin A Thursky^{1

2

3

4

5}, Laura Y Hardefeldt^{1

6}, Arjun Rajkhowa^{1

2}, Courtney Ierano^{1

2}, Jaclyn Bishop^{1

2

7}, Lesley Hawes^{1

8}, Ruby Biezen^{1

8

9}, Sajal K Saha^{1

8}, Leslie Dowson^{1

10}, Kirsten E Bailey^{1

6}, Ri Scarborough^{1

6}, Stephen B Little^{1

6}, Fiona Gotterson^{1

2}, Brian Hur^{1

6}, Anna Khanina^{1

5}, Karen Urbancic^{1

2}, Helen K Crabb^{1

6}, Suzanna Richards^{1

6}, Anna Sri^{1

6}, Rodney James^{1

4}, David C M Kong^{1

7

10}, Caroline Marshall^{1

2

3}, Danielle Mazza^{1

8}, Trisha Peel^{1

11}, Rhonda L Stuart^{1

12}, Jo-Anne Manski-Nankervis^{1

9}, N Deborah Friedman^{1

13}, Noleen Bennett^{1

2

4

14}, Thomas Schulz^{1

2

3}, Helen Billman-Jacobe^{1

6}, Evette Buono^{1

15}, Leon Worth^{1

2

5}, Ann Bull^{1

14}, Michael Richards^{1

3

14}, Darshini Ayton^{1

16}, James R Gilkerson^{1

6}, Glenn F Browning^{1

6}, Kirsty L Buising^{1

2

3

4

17}; National Centre for Antimicrobial Stewardship

Affiliations

¹ NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia.
² Department of Infectious Diseases, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia.
³ Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne Health, 300 Grattan Street, Parkville, Victoria 3050, Australia.
⁴ Guidance Group, Royal Melbourne Hospital, Melbourne Health, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia.
⁵ National Centre for Infections in Cancer, Sir Peter MacCallum Department of Oncology, University of Melbourne and Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Victoria 3000, Australia.
⁶ Asia-Pacific Centre for Animal Health, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Corner Park Drive and Flemington Road, Building 400, Parkville, Victoria 3010, Australia.
⁷ Pharmacy Department, Ballarat Health Services, 1 Drummond Street North, Ballarat, Victoria 3353, Australia.
⁸ Department of General Practice, Monash University, 1/270 Ferntree Gully Road, Notting Hill, Victoria 3168, Australia.
⁹ Department of General Practice, University of Melbourne, 780 Elizabeth Street, Melbourne, Victoria 3010, Australia.
¹⁰ Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia.
¹¹ Department of Infectious Diseases, The Alfred and Central Clinical School, Burnet Institute, Monash University and Alfred Health, 85 Commercial Road, Monash University, Melbourne, Victoria 3004, Australia.
¹² Departments of Infectious Diseases and Infection Control and Epidemiology, Monash Medical Centre, Monash Health, 246 Clayton Road, Clayton, Victoria 3168, Australia.
¹³ Department of Infectious Diseases, University Hospital Geelong, Barwon Health, Bellerine Street, Geelong, Victoria 3220, Australia.
¹⁴ VICNISS Coordinating Centre, Melbourne Health, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia.
¹⁵ New South Wales Clinical Excellence Commission, 1 Reserve Road, St Leonards, New South Wales 2065, Australia.
¹⁶ Department of Epidemiology and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria 3004, Australia.
¹⁷ Peter Doherty Institute of Infection and Immunity, 792 Elizabeth Street, Melbourne Victoria, 3000, Australia.

Abstract

Antimicrobial stewardship (AMS) in Australia is supported by a number of factors, including enabling national policies, sectoral clinical governance frameworks and surveillance programmes, clinician-led educational initiatives and health services research. A One Health research programme undertaken by the National Centre for Antimicrobial Stewardship (NCAS) in Australia has combined antimicrobial prescribing surveillance with qualitative research focused on developing antimicrobial use-related situational analyses and scoping AMS implementation options across healthcare settings, including metropolitan hospitals, regional and rural hospitals, aged care homes, general practice clinics and companion animal and agricultural veterinary practices. Qualitative research involving clinicians across these diverse settings in Australia has contributed to improved understanding of contextual factors that influence antimicrobial prescribing, and barriers and facilitators of AMS implementation. This body of research has been underpinned by a commitment to supplementing 'big data' on antimicrobial prescribing practices, where available, with knowledge of the sociocultural, technical, environmental and other factors that shape prescribing behaviours. NCAS provided a unique opportunity for exchange and cross-pollination across the human and animal health programme domains. It has facilitated synergistic approaches to AMS research and education, and implementation of resources and stewardship activities. The NCAS programme aimed to synergistically combine quantitative and qualitative approaches to AMS research. In this article, we describe the qualitative findings of the first 5 years.

Publication types

Review