695. Physician Perceptions and Attitudes Towards an Antimicrobial Stewardship Program and Computerized Decision-making Systems: A Focus Group Study
Session: Poster Abstract Session: Stewardship: Data and Program Planning
Thursday, October 5, 2017
Room: Poster Hall CD
  • IDWeek poster (Focus group).pdf (2.9 MB)
  • Background:

    Antimicrobial stewardship programs (ASPs) often employ multi-pronged strategies, including Computerized Decision Support Systems (CDSSs), to promote appropriate hospital antibiotic prescribing. Physicians are key determinants of the program’s effectiveness; yet little is known about their attitudes towards these interventions. We aimed to examine hospital physicians’ attitudes toward ASPs and their delivery via computerized systems, and their potential influence on physician antibiotic prescribing habits.


    The focus group study was conducted in a large acute tertiary care teaching hospital in Singapore. We recruited physicians by purposive sampling and snowballing. Focus group discussions (FGDs) for junior and senior physicians were conducted separately. They were audio-recorded and transcripts were independently coded with subsequent adjudication. Major themes on facilitators and barriers to the adoption of ASPs were extracted. FGDs and coding occurred concurrently, consistent with the grounded theory approach.


    Twenty-nine junior physicians and eight senior physicians participated in six and two FGDs respectively. Theme saturation was achieved. Two motivators for adoption of ASPs were: (1) helpfulness of ASP initiatives/strategies; and (2) ASP team members’ proactive contact, both of which guide antibiotic prescription. Four barriers were identified: (1) the primary team’s clinical judgment is deemed of utmost importance; (2) the attending physician makes the final decision; (3) lack of awareness of ASP initiatives/strategies; and (4) complexity of the CDSS.


    Themes extracted from the FGDs revealed that communication and education has a major influence on the adoption of ASP. The authors proposed a set of solutions for enhanced uptake of ASP initiatives through inter-professional collaboration. Future work is needed to identify the best and most effective methods to enhance collaboration between the physicians and the ASP team to improve antibiotic prescribing habits.

    Alvin Qijia Chua, BSc (Pharm) (Hons)1, Sing Teang Kong, PhD1, Lai Wei Lee, BSc (Pharm) (Hons)1, Daphne Yah Chieh Yii, BPharm1, Sarah Si Lin Tang, BSc (Pharm) (Hons)1, Winnie Lee, BPharm (Hons), MSc (Epi)1, Andrea L. Kwa, PharmD1,2,3 and Desiree Lie, MD, MSED2, (1)Pharmacy, Singapore General Hospital, Singapore, Singapore, (2)Duke-National University of Singapore Medical School, Singapore, Singapore, (3)Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore


    A. Q. Chua, None

    S. T. Kong, None

    L. W. Lee, None

    D. Y. C. Yii, None

    S. S. L. Tang, None

    W. Lee, None

    A. L. Kwa, None

    D. Lie, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 4th with the exception of research findings presented at the IDWeek press conferences.