New project :

The OrA-NEAT project (Organization and Attitudes in Nursing home Antibiotic sTewardship) concerns the development and evaluation of a customizable program for the proper use of adapted to the needs of French EHPADs based on an overall evaluation of organizations and perceptions health professionals.

Managed by the University of Lorraine, it involves several partners including the CSO over a period of 6 years.

Summary

Despite growing evidence about their effectiveness in both animal and human medicine, implementation of antimicrobial stewardship (AMS) programs remains suboptimal. Interventions included in these programs target multiple professional behavior change, e.g. antibiotic (AB) prescription. Such interventions are prone to interactions with the context, e.g. adaptation of AMS interventions to local resources, moderating their impact once transferred in another setting. Accordingly, they require specific development and evaluation methods, with special attention paid to capacity building and the context in which they are embedded. So far, studies assessing AMS programs have paid little attention to the theory underpinning their development and to their scalability. While epidemiology and infectious disease expertise are critical to develop and to evaluate AMS programs, social sciences are of particular interest to untangle sociocultural and psychological factors driving AB use; and to develop interventions targeting behavior change.

Based on our previous development of an interdisciplinary approach to interventional research, we propose a new methodological framework for AMS program development and evaluation including four key components: (i) Elaboration of a conceptual framework of the sociocultural context underpinning AB use; (ii) Development of a contextual diagnostic tool on AMS; (iii) Development of an AMS toolkit and implementation support suited to the context of interest; and (iv) Evaluation of the resulting AMS program with the highest level of evidence. We will then apply this methodological framework to a specific context particularly prone to antimicrobial resistance (AMR) and that has been largely understudied, i.e. nursing homes (NHs).