REducing Antimicrobials in Care Homes (REACH)
Research type
Research Study
Full title
An evaluation of a multi-faceted intervention to reduce antimicrobial prescribing in care home residents [REducing Antimicrobials in Care Homes (REACH)]: a non-randomised feasibility study and process evaluation
IRAS ID
186165
Contact name
Carmel Hughes
Contact email
Sponsor organisation
Queen's University Belfast
Duration of Study in the UK
1 years, 11 months, 28 days
Research summary
Concerns have been raised about the level of prescribing of antimicrobials (antibiotics, antifungals and antivirals) in care homes, with such facilities an important ‘reservoir’ of antimicrobial resistance. In this non-randomised study, we will test the feasibility of a multifaceted intervention in six care homes (with and without nursing care) across Northern Ireland (NI) and England (Coventry/Warwickshire). We will adapt and refine an intervention previously shown to be effective in a Canadian study for use in the United Kingdom (UK). We will present the proposed intervention (see below) to stakeholders (focus groups with care home staff and family members and semi-structured interviews with general practitioners-GPs) who will be asked to comment on and amend the content of the intervention. The proposed intervention consists of education and training of care home staff and the GPs caring for pilot home residents, on appropriate management of common infections and antimicrobial stewardship. This will be achieved via visits to the care homes and practices, including training on the implementation of algorithms to guide recognition of signs and symptoms and treatment for infections by home staff and GPs. The intervention will be a complex whole home intervention targeting home staff and their linked general practices, focusing on use of antimicrobials in care homes with an implementation phase running for 6 months. A detailed process evaluation will run throughout the pilot study to assess whether care homes can be recruited to the study, the implementation and acceptability of the intervention, and how home staff and general practices interact. We will also test our approaches to data collection from care homes and community pharmacies, the assessment of appropriateness of prescribing, and determination of event rates for sample size calculations to inform a larger study.
REC name
HSC REC B
REC reference
16/NI/0003
Date of REC Opinion
28 Jan 2016
REC opinion
Further Information Favourable Opinion