Understanding context to plan antimicrobial stewardship: A mixed-method study in a Brazilian urban primary care - 15/04/25
, Vítor Falcão de Oliveira, PhD b, Maria Tereza Pepe Razzolini, PhD c, Fátima L.S. Nunes, PhD d, Gabriela Tonon de Oliveira Xavier, MSc e, Erika Regina Manuli, MSc b, f, h, Fábio Eudes Leal, PhD f, k, Regina Maura Zetone Grespan, BSc f, Cibele Cristine Remondes Sequeira, BSc e, f, Meiryellen Midiã Macedo, RN e, Ester Cerdeira Sabino, PhD b, f, h, Alison Holmes, PhD g, Silvia Figueiredo Costa, PhD b, h, i, Anna S. Levin, PhD b, i, j, Maria Clara Padoveze, PhD aon behalf of CAMO-Net Brazil Study Group1
Résumé |
Background |
The Centres for Antimicrobial Optimization Network Brazil aims to implement an antimicrobial stewardship program in Brazilian municipality. This study explores barriers and enablers to its implementation, through understanding the context and beliefs regarding antimicrobial use in this environment.
Methods |
The study occurred in 12 primary health care units, where a mixed-method study was conducted. A total of 208 out of 450 health care workers completed a Theoretical Domain Framework-based survey, and 16 patients and 12 health workers were interviewed. Survey results were compared by professional category; interviews were analyzed using Critical Discourse Analysis.
Results |
Professionals with higher education scored higher across most domains. In the “Optimism” domain, these professionals scored ≥6.0, while others scored ≤5.0. Similar patterns were observed in the domains “Knowledge” (≥6.0 vs ≤5.5), “Social/professional role and identity” (≥6.36 vs ≤5.79), and “Intentions” (≥6.0 vs ≤5.0). Qualitative data highlighted breaks in the continuity of care and gaps in patient knowledge about antimicrobial use. Key barriers included disparities in training, physician-centered decision-making, and patient knowledge gaps. Enablers included health care workers' willingness to learn and home caregivers' understanding of patient conditions.
Conclusions |
The implementation of the antimicrobial stewardship program depends on addressing training disparities and leveraging health care workers' willingness to learn.
Le texte complet de cet article est disponible en PDF.Graphical Abstract |
Highlights |
• | Knowledge gaps in antimicrobial use and breaks in the continuity of care were identified. |
• | Training disparities and physician-centered decision-making were key barriers. |
• | Caregivers and healthcare workers' willingness to learn were key enablers. |
Key Words : Antimicrobial drugs, Primary health care, Qualitative research, Surveys and questionnaires
Plan
| Conflicts of interest: None to report. |
|
| Funding/support: CAMO-Net is funded by Wellcome Trust (Grant No. 226693/Z22/Z). |
Vol 53 - N° 5
P. 619-627 - mai 2025 Retour au numéro
Article précédent
- Fluoroquinolone consumption and resistance after an Antibiotic Stewardship Team intervention—An interventional study in a single hospital in Southern Poland from 2018 to 2023
- P. Serwacki, D.A. Hareza, M. Gajda, W. Świątek-Kwapniewska, M. Adamowska, K. Serwacka, G. Zawada, M. Wałaszek, J. Wójkowska-Mach
- The impact of implementing a strategy on the rate reduction of catheter-associated urinary tract infections (CAUTI) in national health care facilities in Saudi Arabia
- Fayez Aldalbehi, Faisal Mohammad Alsheddi, Mohammad Ali Alqahtani, Tabish Humayun, Yvonne Suzette Aldecoa, Mutlaq Alotaibi, Wafa Hamad Alshammari, Shmokh Mohammad Alsalamah, Hind Owyed Alanizi, Mishari Saud Almana, Bader Mohammed Albalawai, Amani Mahal Alaida, Khalid H. Alanazi
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?