Digital Fragmentation and Acceptability of Antibiotic Passports (DFAP)
Research type
Research Study
Full title
Exploring patient, carer and staff experiences of digital fragmentation and the acceptability of a patient-held digital antibiotic passport
IRAS ID
366547
Contact name
Steve Harris
Contact email
Sponsor organisation
University College London
Clinicaltrials.gov Identifier
Z6364106/2025/12/88 , UCL Data Protection Registration Number
Duration of Study in the UK
1 years, 0 months, days
Research summary
Antimicrobial stewardship (AMS); the promotion and monitoring judicious antimicrobial use to preserve their future effectiveness is essential in controlling the rise of AMR. For effective antimicrobial prescribing and decision making, optimising data sharing between healthcare settings is key. However, incomplete healthcare data or systems across the NHS (digital fragmentation) is a persistent barrier for staff and patients. For AMS, fragmentation can delay or complicate safe antibiotic prescribing because clinicians cannot access data on patients’ prior exposure to antibiotics, or previous infection test history, contributing to suboptimal care and antimicrobial resistance, particularly for patients who utilise multiple healthcare services. Certain patient groups are at heightened risk of severe outcomes of AMR following suboptimal antimicrobial therapy such as individuals with recurrent urinary tract infections (UTIs) where the bacterial infection contributing to the infection is increasingly resistant to first line antibiotic treatment. Similarly, those undergoing cancer treatment are especially vulnerable to AMR due to weakened immune systems and chemotherapy resulting in susceptibility to an infection.
There is a clear opportunity to reduce treatment failure and antibiotic related side effects by sharing data across healthcare systems for timely and more accurate antimicrobial prescribing decisions. This requires a better understanding of the challenges posed by digital fragmentation and exploring solutions for improved data integration. One potential innovation is the development of a digital “antibiotic passport”, allowing patients to carry and share their own infection test results and antibiotic prescribing history across healthcare settings. However, in order to optimise these digital tools, to enable their use and adoption, and for their successful implementation in real world settings, such tools must be co-designed with users and grounded in an understanding of the behavioural factors influencing their usability and acceptability. This project aims to understand the lived experiences of patients and carers as they seek treatment for infection across health and care settings, as well as the views of healthcare professionals on antibiotic prescribing, access to microbiology history, and digital fragmentation. It will also investigate the acceptability and perceived utility of a potential patient-held digital ‘antibiotic passport’ and how we can integrate this data within electronic healthcare records. A theory based, qualitative study, informed by behavioural science frameworks, will utilise semi-structured interviews with patients, carers and healthcare professionals across UCLH services, with a focus on UTI and cancer care pathways.
REC name
East of England - Essex Research Ethics Committee
REC reference
26/EE/0090
Date of REC Opinion
13 Apr 2026
REC opinion
Favourable Opinion