Interventions
PHE lead: Julie Robotham
Oxford University co-lead: Chris Butler
We will use this information generated in the populations theme to work out how we can reduce healthcare-associated infections and antimicrobial resistance, in ways the NHS can afford and that target those at highest risk. We will explore whether we should use drugs, tests for infections and vaccinations differently; or change the ways healthcare professionals interact with patients, empowering patients to manage their health and antibiotic use better.
Our strategy is to use multidisciplinary approaches to determine how antibiotic prescribing in primary care cab be sustainably reduced to the minimum safe level and how can national, hospital and patient-focused approaches be combined to improve management and outcomes of AMR and HAI. We hope this will improve the effectiveness and cost-effectiveness of antimicrobial management and provide information on how to control difficult to treat infections.
Strategy
To exploit multi-disciplinary approaches to complex interventions to answer the following key questions:
- How can antibiotic prescribing in primary care be sustainably reduced to the minimum safe level?
- How can national, hospital and patient-focused approaches be integrated to improve management and outcomes for AMR&HAI?
4 overarching projects ongoing and planned, encompassing a portfolio of research
Interventions Theme Publications
Prospective trial of different antimicrobial treatment durations for presumptive canine urinary tract infections
Allerton F, Pouwels K, Bazelle J, Caddy S, Cauvin A, De Risio, Swann J, Warland J, Kent A
https://bmcvetres.biomedcentral.com/articles/10.1186/s12917-021-02974-y
Investigating the mechanism of impact and differential effect of the Quality Premium scheme on antibiotic prescribing in England: a longitudinal study
Anyanwu P, Pouwels K, Walker A, Moore M, Majeed A, Hayhoe B, Tonkin-Crine S, Borek A, Hopkins S, Mcleod M, Costelloe C
https://bjgpopen.org/content/4/3/bjgpopen20X101052
Social and contextual influences on antibiotic prescribing and antimicrobial stewardship: A qualitative study with clinical commissioning group and general practice professionals
Borek AJ, Anthierens S, Allison R, Mcnulty CAM, Anyanwu PE, Costelloe C, Walker A, Bulter C, Tonkin-Crine S, STEP-UP Study Team
https://www.mdpi.com/2079-6382/9/12/859
STEP-UP study team. Implementing interventions to reduce antibiotic use: a qualitative study in high-prescribing practices
Borek A, Campbell A, Dent E, Butler C, Holmes A, Moore M, Walker A, Mcleod M, Tonkin-Crine S, STEP-UP Study Team
https://bmcprimcare.biomedcentral.com/articles/10.1186/s12875-021-01371-6
Optimising antimicrobial stewardship interventions in English primary care: a behavioural analysis of qualitative and intervention studies
Borek A, Wanat M, Akins L, Sallis A, Ashiru-Oredope D, Beech E, Butler C, Chadborn T, Hopkins S, Jone L, McNulty C, Robert N, Shaw K, Taborn E, Tonkin-Crine S
https://bmjopen.bmj.com/content/10/12/e039284.long
How did a Quality Premium financial incentive influence antibiotic prescribing in primary care? Views of Clinical Commissioning Group and general practice professionals?
Borek A, Anthierens S, Allison R, McNulty C, Lecky D, Costelloe C, Holmes A, Butler C, Walker A, Tonkin-Crine S,
https://academic.oup.com/jac/article/75/9/2681/5861493
Development of an intervention to support the implementation of evidence-based strategies for optimising antibiotic prescribing in general practice
Borek A, Campbell A, Dent E, Moore M, Butler CC, Holmes A, Walker AS, Mcleod M, Tonkin-Crine S, Anyanwu PE, Borek AJ, Bright N, Buchanan J, Butler CC, Campbell A, Costelloe C, Hayhoe B, Holmes A, Hopkins S, Majeed A, Mcleod M, Moore M, Morrell L, Pouwels KB, Robotham JV, Roope LSJ, Tonkin-Crine S, Walker AS, Wordsworth S, Wright C, Yadav S, Zalevski A
https://implementationsciencecomms.biomedcentral.com/articles/10.1186/s43058-021-00209-7
Impact of the COVID-19 Pandemic on Community Antibiotic Prescribing and Stewardship: A Qualitative Interview Study with General Practitioners in England
Borek A, Maitland K, Mcleod M, Campbell A, Hayhoe B, Butler C, Morrell L, Roope L, Holmes S, Walker A, Tonkin-Crine S, STEP-UP Study Team
https://www.mdpi.com/2079-6382/10/12/1531
Preferences for Medical Consultations from Online Providers: Evidence from a Discrete Choice Experiment in the United Kingdom
Buchanan J, Roope L, Morrell L, Pouwels K, Robotham J, Abel L, Crook D, Peto T, Butler C, Walker A, Wordsworth S
https://link.springer.com/article/10.1007/s40258-021-00642-8
Following the science? Views from scientists on government advisory boards during the COVID-19 pandemic: a qualitative interview study in five European countries
Colman E, Wanat M, Goossens H, Tonkin-Crine S, Anthierens S
https://gh.bmj.com/content/6/9/e006928
Understanding how community antiretroviral delivery influences engagement in HIV are: a qualitative assessment of the Centralised Chronic Medication Dispensing and Distribution programme in South Africa
Dorward J, Msimango L, Gibbs A, Shozi H, Tonkin-Crine S, Hayward G, Butler C, Ngobese H, Drain P, Garrett N
https://bmjopen.bmj.com/content/10/5/e035412#
Protocol for a randomised feasibility study of Point-Of-care HIV viral load testing to Enhance Re-suppression in South Africa: the POwER study
Dorward J, Sookrajh Y, Ngobese H, Lessells R, Sayed F, Bulo E, Moodley P, Samsunder N, Lewis L, Tonkin-Crine S, Drain P, Hayward G, Butler C, Garrett N
https://bmjopen.bmj.com/content/11/2/e045373
Probabilistic transmission models incorporating sequencing data for healthcare-associated Clostridioides difficile outperform heuristic rules and identify strain-specific differences in transmission
Eyre D, Laager M, Walker AS, Cooper BS, Wilson DJ
https://journals.plos.org/ploscompbiol/article?id=10.1371/journal.pcbi.1008417
Feasibility and Acceptability of Community Coronavirus Disease 2019 Testing Strategies (FACTS) in a University Setting
Hirst J, Logan M, Fanshaww TR, Mwandigha L, Wanat M, Vicary C, Perera R, Tonkin-Crine S, Lee JJ, Tracey I, Duff G, Tufano P, Besharov M, Tarassenko L, Nicholson BD, Hobbs FDR
https://academic.oup.com/ofid/article/8/12/ofab495/6380918
Perspectives on COVID-19 testing policies and practices: a qualitative study with scientific advisors and NHS health care workers in England
Martindale A, Pilbeam C, Mableson H, Tonkin-Crine S, Atkinson P, Borek A, Lant S, Gobat N, Solomon T, Sheard S
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-11285-8
Delayed antibiotic prescription by general practitioners in the UK: A stated-choice study
Morrell L, Buchanan J, Roope L, Pouwels K, Butler C, Hayhoe B, Moore M, Tonkin-Crine S, McLeod M, Robotham J, Walker S, STEP-UP team
https://www.mdpi.com/2079-6382/9/9/608
Public preferences for delayed or immediate antibiotic prescriptions in UK primary care: A choice experiment
Morrell L, Buchanan J, Roope LSJ, Pouwels KB, Butler CC, Hayhoe B, Tonkin-Crine S, Mcleod M, Robotham JV, Holmes A, Walker AS, Wordsworth S
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003737
Improving the uptake and SusTainability of Effective interventions to promote Prudent antibiotic Use and Primary care (STEP-UP) Team, Estimating the Effect of Healthcare-Associated Infections on Excess Length of Hospital Stay Using Inverse Probability–Weighted Survival Curves
Pouwels K, Vansteelandt S, Batra R, Edgeworth J, Wordsworth S, Robotham J, Anyanwu P, Borek A, Bright N, Buchanan J, Butler C, Campbell A, Costelloe C, Hayhoe B, Holmes A, Hopkins S, Majeed A, McLeod M, Moore M, Morrell L, Pouwels K, Robotham J, Roope L, Tonkin-Crine S, Walker A, Wordsworth S, Zalevski A
https://academic.oup.com/cid/article/71/9/e415/5734540
Awareness of appropriate antibiotic use in primary care for influenza-like illness: evidence of improvement from UK population-based surveys
Pouwels KB, Roope LSJ, Buchanan J, Morrell L, Tonkin-Crine S, Peters M, Jones L, Castro-Sánchez E, Crook D, Peto T, Butler C, Robotham J, Walker A, Wordsworth S
https://www.mdpi.com/2079-6382/9/10/690
Why do hospital prescribers continue antibiotics when it is safe to stop? Results of a choice experiment survey
Roope L, Buchanan J, Morrell L, Pouwels K, Sivyer K, Mowbray F, Abel L, Cross E, Yardley L, Peto T, Walker A, Llewelyn M, Wordsworth S
https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-020-01660-4
Reducing expectations for antibiotics in primary care: a randomised experiment to test the response to fear-based messages about antimicrobial resistance
Roope L, Tonkin-Crine S, Herd N, Michie S, Pouwels K, Castro-Sanchez E, Sallis A, Hopkins S, Robotham J, Crook D, Peto T, Peters M, Butler C, Walker A, Wordsworth S
https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-020-01553-6
Prescriber Commitment Posters to Increase Prudent Antibiotic Prescribing in English General Practice: A Cluster Randomized Controlled Trial
Sallis A, Bondaronek P, Sanders J, Yu L, Harris V, Vlaev I, Sanders M, Tonkin-Crine S, Chadborn T
https://www.mdpi.com/2079-6382/9/8/490
Developing a behavioural intervention package to identify and amend incorrect penicillin allergy records in UK general practice and subsequently change antibiotic use
Santillo M, Wanat M, Davoudianfar M, Bongard E, Savic S, Savic L, Porter C, Fielding J, Butler C, Pavitt S, Sandoe J, Tonkin-Crine S
https://bmjopen.bmj.com/content/10/10/e035793
Experiences and needs of persons living with a household member infected with SARS-CoV-2: A mixed method study
Verberk J, Anthierens S, Tonkin-Crine S, Goossens H, Kinsman J, de Hoog M, Bielicki J, Bruijning-Verhagen P, Gobat N
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0249391
Transformation of primary care during the COVID-19 pandemic: experiences of healthcare professionals in eight European countries
Wanat M, Hoste M, Gobat N, Anastasaki M, Böhmer F, Chlabicz S, Colliers A, Farrell K, Karkana M-N, Kinsman J, Lionis C, Marcinowicz L, Reinhardt K, Skoglund I, Sundvall P-D, Vellinga Akke, Verheij T, Goossens H, Butler C, van der Velden A, Anthierens S, Tonkin-Crine S
https://bjgp.org/content/71/709/e634
Optimising Interventions for Catheter-Associated Urinary Tract Infections (CAUTI) in Primary, Secondary and Care Home Settings
Wanat M, Logan M, Hirst J, Vicary C, Lee J, Perera R, Tracey I, Duff G, Tufano P, Fanshawe T, Mwandigha L, Nicholson B, Tonkin-Crine S, Hobbs R
https://www.mdpi.com/2079-6382/9/7/419
Perceptions on undertaking regular asymptomatic self-testing for COVID-19 using lateral flow tests: a qualitative study of university students and staff
Wanat M, Logan M, Hirst J, Vicary C, Lee J, Perera R, Tracey I, Duff G, Tufano P, Fanshawe T, Mwandigha L, Nicholson B, Tonkin-Crine S, Hobbs R
https://bmjopen.bmj.com/content/11/9/e053850
Management of penicillin allergy in primary care: a qualitative study with patients and primary care physicians
Wanat M, Anthierens S, Butler C, Savic L, Savic S, Pavitt S, Sandoe JAT, Tonkin-Crine S
https://bmcprimcare.biomedcentral.com/articles/10.1186/s12875-021-01465-1
Supporting Primary Care Professionals to Stay in Work During the COVID-19 Pandemic: Views on Personal Risk and Access to Testing During the First Wave of Pandemic in Europe
Wanat M, Hoste M, Gobat N, Anastaski M, Bohmer F, Chlaicz S, Colliers A, Farrell K, Karkana M, Kinsman J, Lionis C, Marcinowicz L, Reinhardt K, Skogulnd I, Sundvall P, Vellingna A, Goossens H, Butler C, Velden AVD, Anthierens S, Tonkin-Crine S
https://www.frontiersin.org/articles/10.3389/fmed.2021.726319/full