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Driving sustainable change in antimicrobial prescribing practice – How can social and behavioural sciences help?

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posted on 2018-06-07, 08:47 authored by Fabiana Lorencatto, Esmita Charani, Nick Sevdalis, Carolyn Tarrant, Peter Davey
Addressing the growing threat of antimicrobial resistance is in part reliant on the complex challenge of changing human behaviour- in terms of reducing inappropriate antibiotic use and preventing infection. Whilst there is no ‘one size fits all’ recommended behavioural solution for improving antimicrobial stewardship, the behavioural and social sciences offer a range of theories, frameworks, methods and evidence-based principles that can help inform the design of behaviour change interventions that are context-specific and thus more likely to be effective. However the state-of-the art in antimicrobial stewardship research and practice suggests that behavioural and social influences are often not given due consideration in the design and evaluation of interventions to improve antimicrobial prescribing. In this paper, we discuss four potential areas where the behavioural and social sciences can help drive more effective and sustained behaviour change in antimicrobial stewardship: 1) defining the problem in behavioural terms and understanding current behaviour in context; 2) adopting a theory-driven, systematic approach to intervention design; 3) investigating implementation and sustainability of interventions in practice; and 4) maximising learning through evidence synthesis and detailed intervention reporting.

Funding

E Charani is funded by National Institute of Health Research Imperial Biomedical Research Centre and the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London in partnership with Public Health England and the NIHR Imperial Patient Safety Translational Research Centre and the Economic and Social Research Council. N Sevdalis’ research is supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London at King’s College Hospital NHS Foundation Trust. NS is a member of King's Improvement Science, which is part of the NIHR CLAHRC South London and comprises a specialist team of improvement scientists and senior researchers based at King's College London. Its work is funded by King's Health Partners (Guy's and St Thomas’ NHS Foundation Trust, King's College Hospital NHS Foundation Trust, King's College London and South London and Maudsley NHS Foundation Trust), Guy's and St Thomas’ Charity, the Maudsley Charity and the Health Foundation. N Sevdalis’ research is further supported by the Economic and Social Research Council grant ES/P008313/1. F Lorencatto & C Tarrant were partly supported by grant ES/P008321/1 (FL & CT) and ES/P008224/1 (FL), awarded through the Antimicrobial Resistance Cross Council Initiative supported by the seven research councils.

History

Citation

Journal of Antimicrobial Chemotherapy, 2018, dky222

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Health Sciences

Version

  • AM (Accepted Manuscript)

Published in

Journal of Antimicrobial Chemotherapy

Publisher

Oxford University Press (OUP) for British Society for Antimicrobial Chemotherapy

issn

0305-7453

eissn

1460-2091

Acceptance date

2018-05-17

Copyright date

2018

Available date

2019-07-17

Publisher version

https://academic.oup.com/jac/advance-article/doi/10.1093/jac/dky222/5055403

Notes

The file associated with this record is under embargo until 12 months after publication, in accordance with the publisher's self-archiving policy. The full text may be available through the publisher links provided above.

Language

en

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