Evaluation of an OPEN Stewardship generated feedback intervention to improve antibiotic prescribing among primary care veterinarians in Ontario, Canada and Israel: protocol for evaluating usability and an interrupted time-series analysis

Introduction Antimicrobial resistance (AMR) impacts the health and well-being of animals, affects animal owners both socially and economically, and contributes to AMR at the human and environmental interface. The overuse and/or inappropriate use of antibiotics in animals has been identified as one o...

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Autores principales:	Derek R MacFadden, Nadav Davidovitch, Moriah Ellen, Jean-Paul R Soucy, Kamal Raj Acharya, Anette Hulth, Sonja Löfmark, Jacob Moran-Gilad, David N Fisman, Gabrielle Brankston, Adar Cohen, Amir Steinman, Amy L Greer
Formato:	article
Lenguaje:	EN
Publicado:	BMJ Publishing Group 2021
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/4072c5cd7ac74139b66959f5e0466ee6
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spelling	oai:doaj.org-article:4072c5cd7ac74139b66959f5e0466ee62021-11-18T10:00:05ZEvaluation of an OPEN Stewardship generated feedback intervention to improve antibiotic prescribing among primary care veterinarians in Ontario, Canada and Israel: protocol for evaluating usability and an interrupted time-series analysis10.1136/bmjopen-2020-0397602044-6055https://doaj.org/article/4072c5cd7ac74139b66959f5e0466ee62021-01-01T00:00:00Zhttps://bmjopen.bmj.com/content/11/1/e039760.fullhttps://doaj.org/toc/2044-6055Introduction Antimicrobial resistance (AMR) impacts the health and well-being of animals, affects animal owners both socially and economically, and contributes to AMR at the human and environmental interface. The overuse and/or inappropriate use of antibiotics in animals has been identified as one of the most important drivers of the development of AMR in animals. Effective antibiotic stewardship interventions such as feedback can be adopted in veterinary practices to improve antibiotic prescribing. However, the provision of dedicated financial and technical resources to implement such systems are challenging. The newly developed web-based Online Platform for Expanding Antibiotic Stewardship (OPEN Stewardship) platform aims to automate the generation of feedback reports and facilitate wider adoption of antibiotic stewardship. This paper describes a protocol to evaluate the usability and usefulness of a feedback intervention among veterinarians and assess its impact on individual antibiotic prescribing.Methods and analysis Approximately 80 veterinarians from Ontario, Canada and 60 veterinarians from Israel will be voluntarily enrolled in a controlled interrupted time-series study and their monthly antibiotic prescribing data accessed. The study intervention consists of targeted feedback reports generated using the OPEN Stewardship platform. After a 3-month preintervention period, a cohort of veterinarians (treatment cohort, n=120) will receive three feedback reports over the course of 6 months while the remainder of the veterinarians (n=20) will be the control cohort. A survey will be administered among the treatment cohort after each feedback cycle to assess the usability and usefulness of various elements of the feedback report. A multilevel negative-binomial regression analysis of the preintervention and postintervention antibiotic prescribing of the treatment cohort will be performed to evaluate the impact of the intervention.Ethics and dissemination Research ethics board approval was obtained at each participating site prior to the recruitment of the veterinarians. The study findings will be disseminated through open-access scientific publications, stakeholder networks and national/international meetings.Derek R MacFaddenNadav DavidovitchMoriah EllenJean-Paul R SoucyKamal Raj AcharyaAnette HulthSonja LöfmarkJacob Moran-GiladDavid N FismanGabrielle BrankstonAdar CohenAmir SteinmanAmy L GreerBMJ Publishing GrouparticleMedicineRENBMJ Open, Vol 11, Iss 1 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Derek R MacFadden Nadav Davidovitch Moriah Ellen Jean-Paul R Soucy Kamal Raj Acharya Anette Hulth Sonja Löfmark Jacob Moran-Gilad David N Fisman Gabrielle Brankston Adar Cohen Amir Steinman Amy L Greer Evaluation of an OPEN Stewardship generated feedback intervention to improve antibiotic prescribing among primary care veterinarians in Ontario, Canada and Israel: protocol for evaluating usability and an interrupted time-series analysis
description	Introduction Antimicrobial resistance (AMR) impacts the health and well-being of animals, affects animal owners both socially and economically, and contributes to AMR at the human and environmental interface. The overuse and/or inappropriate use of antibiotics in animals has been identified as one of the most important drivers of the development of AMR in animals. Effective antibiotic stewardship interventions such as feedback can be adopted in veterinary practices to improve antibiotic prescribing. However, the provision of dedicated financial and technical resources to implement such systems are challenging. The newly developed web-based Online Platform for Expanding Antibiotic Stewardship (OPEN Stewardship) platform aims to automate the generation of feedback reports and facilitate wider adoption of antibiotic stewardship. This paper describes a protocol to evaluate the usability and usefulness of a feedback intervention among veterinarians and assess its impact on individual antibiotic prescribing.Methods and analysis Approximately 80 veterinarians from Ontario, Canada and 60 veterinarians from Israel will be voluntarily enrolled in a controlled interrupted time-series study and their monthly antibiotic prescribing data accessed. The study intervention consists of targeted feedback reports generated using the OPEN Stewardship platform. After a 3-month preintervention period, a cohort of veterinarians (treatment cohort, n=120) will receive three feedback reports over the course of 6 months while the remainder of the veterinarians (n=20) will be the control cohort. A survey will be administered among the treatment cohort after each feedback cycle to assess the usability and usefulness of various elements of the feedback report. A multilevel negative-binomial regression analysis of the preintervention and postintervention antibiotic prescribing of the treatment cohort will be performed to evaluate the impact of the intervention.Ethics and dissemination Research ethics board approval was obtained at each participating site prior to the recruitment of the veterinarians. The study findings will be disseminated through open-access scientific publications, stakeholder networks and national/international meetings.
format	article
author	Derek R MacFadden Nadav Davidovitch Moriah Ellen Jean-Paul R Soucy Kamal Raj Acharya Anette Hulth Sonja Löfmark Jacob Moran-Gilad David N Fisman Gabrielle Brankston Adar Cohen Amir Steinman Amy L Greer
author_facet	Derek R MacFadden Nadav Davidovitch Moriah Ellen Jean-Paul R Soucy Kamal Raj Acharya Anette Hulth Sonja Löfmark Jacob Moran-Gilad David N Fisman Gabrielle Brankston Adar Cohen Amir Steinman Amy L Greer
author_sort	Derek R MacFadden
title	Evaluation of an OPEN Stewardship generated feedback intervention to improve antibiotic prescribing among primary care veterinarians in Ontario, Canada and Israel: protocol for evaluating usability and an interrupted time-series analysis
title_short	Evaluation of an OPEN Stewardship generated feedback intervention to improve antibiotic prescribing among primary care veterinarians in Ontario, Canada and Israel: protocol for evaluating usability and an interrupted time-series analysis
title_full	Evaluation of an OPEN Stewardship generated feedback intervention to improve antibiotic prescribing among primary care veterinarians in Ontario, Canada and Israel: protocol for evaluating usability and an interrupted time-series analysis
title_fullStr	Evaluation of an OPEN Stewardship generated feedback intervention to improve antibiotic prescribing among primary care veterinarians in Ontario, Canada and Israel: protocol for evaluating usability and an interrupted time-series analysis
title_full_unstemmed	Evaluation of an OPEN Stewardship generated feedback intervention to improve antibiotic prescribing among primary care veterinarians in Ontario, Canada and Israel: protocol for evaluating usability and an interrupted time-series analysis
title_sort	evaluation of an open stewardship generated feedback intervention to improve antibiotic prescribing among primary care veterinarians in ontario, canada and israel: protocol for evaluating usability and an interrupted time-series analysis
publisher	BMJ Publishing Group
publishDate	2021
url	https://doaj.org/article/4072c5cd7ac74139b66959f5e0466ee6
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Evaluation of an OPEN Stewardship generated feedback intervention to improve antibiotic prescribing among primary care veterinarians in Ontario, Canada and Israel: protocol for evaluating usability and an interrupted time-series analysis

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