1303. Provider Knowledge and Attitudes Towards Antibiotic Prescribing and Antibiotic Stewardship in Outpatient Rural Clinics
Session: Poster Abstract Session: Medical Education
Friday, October 5, 2018
Room: S Poster Hall
Posters
  • IDWeek_2018_Provider Knowledge and Attitudes Towards Antibiotic Prescribing and Antibiotic Stewardship in Outpatient Rural Clinics_Final.pdf (2.5 MB)
  • Background: Rural outpatient clinics serve the healthcare needs of many individuals, especially for acute sick visits and infectious processes. A better understanding of providers' knowledge and attitudes towards antibiotic stewardship in the outpatient rural setting is needed to facilitate more effective education regarding appropriate antibiotic prescribing.

    Methods: A cross-sectional, multi-center, 28-item survey assessing providers' knowledge and attitudes towards antibiotic prescribing and antibiotic stewardship in the rural setting was distributed to providers from Guthrie and United Health Services primary care clinics in rural New York and Pennsylvania.

    Results: Sixty-five providers participated (31% response rate) with 43%, 29%, and 28% of responses from physicians, resident physicians, and advanced practice providers, respectively. More than half of respondents practiced for ≤5 years since terminal training. The most significant barrier to improving antibiotic prescribing was patient demands (55%) followed by uncertain diagnosis of bacterial infection (22%) and short appointment visit times (11%). Providers that spent ≤20 minutes per visit were more likely to feel pressured to prescribe antibiotics for upper respiratory tract infections (URI) to ensure patient satisfaction than those who spent >20 minutes (41% vs. 7%, p=0.024). Additionally, providers who saw >50 patients per week were more likely to feel pressured to prescribe antibiotics for URIs than those who saw 50 patients (50% vs. 18%, p=0.009). Only 42% of providers selected the correct answer that 90-98% of URIs are viral. The majority of providers strongly agreed that antibiotics are overused (71%) and inappropriate antibiotic use can lead to resistance (82%). Thirty-eight percent of providers never heard the term antibiotic stewardship or heard the term but were unsure about the definition. However, more than 75% of providers strongly agreed or agreed that they were interested in receiving more education regarding antibiotic stewardship.

    Conclusion: Variability exists among providers' knowledge and attitudes towards antibiotic stewardship and antibiotic prescribing in rural outpatient settings. Increased educational efforts are warranted to increase consistency of these concepts and practices.

    Wesley Kufel, PharmD, BCPS, AAHIVP1,2,3, Bryan Mogle, PharmD, BCPS, AAHIVP1, Karen Williams, PharmD, BCPS4, James Jester, PharmD5, John Snyder, PharmD, BCPS5, Keri Mastro, BA2, Theresa Lubowski, PharmD6 and KarenBeth Bohan, PharmD, BCPS2, (1)Pharmacy, SUNY Upstate University Hospital, Syracuse, NY, (2)Pharmacy Practice, Binghamton University School of Pharmacy and Pharmaceutical Sciences, Binghamton, NY, (3)Medicine, SUNY Upstate Medical University, Syracuse, NY, (4)Pharmacy, Guthrie Healthcare System, Sayre, PA, (5)Pharmacy, United Health Services Hospitals, Johnson City, NY, (6)IPRO, Albany, NY

    Disclosures:

    W. Kufel, None

    B. Mogle, None

    K. Williams, None

    J. Jester, None

    J. Snyder, None

    K. Mastro, None

    T. Lubowski, None

    K. Bohan, None

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    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.