Development and pilot testing of remote active learning tool as antimicrobial stewardship co-interventions

Purpose: Online education tool is known for its cost-effectivity as antimicrobial stewardship intervention, yet only a limited number of studies was done in developing country settings. This pilot was therefore conducted to assess the feasibility, acceptability, and effect of the prescriber-directed distance learning model and analyze feedback for future intervention. Patients and methods: The research procedure was outlined in preparation, conduct, and evaluation phase under antimicrobial resistance control committee supervision. The preparatory phase included learning tool planning and finalization to be disseminated in the conduct phase. Educational intervention delivery was preceded and followed with pre- and posttest to assess attendings’ knowledge, attitude, and practice regarding AMS and collect feedbacks on intervention components. Test scores were compared using paired t-test, and feedbacks were analyzed as aggregates as barriers or facilitators of AMS intervention. Results: A total of 203 subjects were included in the analysis with 99% recruitment rate and 96.7% adherence rate. Proportions of subjects with adequate knowledge and attitudinal scores improved from initially 36.9% and 21.2% before intervention into 83.3% and 51.7%, respectively. Mean knowledge score in pretest (6.1±1.2) increased significantly in posttest (7.6±1.1) with p-value less than 0.001. Knowledge on antimicrobial classification and prescription workflow were the main topics with the least number of correct answers. Facilitators identified in the feedback were access to workflow, guideline, resistance pattern, and course, while antimicrobial availability was regarded as a barrier to optimal AMS implementation. Conclusion: The findings suggest the feasibility and acceptability of the evaluated protocol. Protocol modification and expansion of study recruitment hold the potential to improve AMS intervention efficacy.

Keywords:

Antibiotic resistance, Antimicrobial stewardship Distance education, Multidisciplinary communication, Pilot study, Prescriber-directed,

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