Barriers and facilitators of appropriate vancomycin use: prescribing context is key.

Purpose: Audit studies reveal frequent non-compliance with dosing and monitoring guidelines for vancomycin. This study aimed to qualitatively explore the barriers and facilitators of compliance with vancomycin dosing and monitoring guidelines.Methods: Interviews were conducted with 16 prescribers in...

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Publicado en:European Journal of Clinical Pharmacology Vol. 74; no. 11; pp. 1523 - 1530
Autores principales: Chan, Joanne Oi Sze, Baysari, Melissa Therese, Carland, Jane Ellen, Sandaradura, Indy, Moran, Maria, Day, Richard Osborne
Formato: research tables/charts Journal Article
Publicado: Springer Nature Nov2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2018
      vid: 74
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      pub: Springer Nature
      place: New York, New York
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        132223044
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        10.1007/s00228-018-2525-2
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        atl: Barriers and facilitators of appropriate vancomycin use: prescribing context is key.
      aug:
        au:
          Chan, Joanne Oi Sze
          Baysari, Melissa Therese
          Carland, Jane Ellen
          Sandaradura, Indy
          Moran, Maria
          Day, Richard Osborne
        affil: School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
      sug:
        subj:
          Health Services Accessibility
          Vancomycin Therapeutic Use
          Medication Compliance
          Vancomycin Administration and Dosage
          Prescriptions, Drug
          Drug Monitoring
          Practice Guidelines
          Human
          Qualitative Studies
          Interviews
          Tertiary Health Care
          Academic Medical Centers
          Australia
          Professional Knowledge
          Attitude of Health Personnel
          Thematic Analysis
          Communication
          Phlebotomists
          Vancomycin Blood
          Health Personnel Education
      ab: Purpose: Audit studies reveal frequent non-compliance with dosing and monitoring guidelines for vancomycin. This study aimed to qualitatively explore the barriers and facilitators of compliance with vancomycin dosing and monitoring guidelines.Methods: Interviews were conducted with 16 prescribers in a large tertiary teaching hospital in Sydney, Australia. Questions explored knowledge, attitudes, and perceived complexities associated with vancomycin use. Interviews were analysed using thematic analysis.Results: Prescribers reported utilising vancomycin guidelines, citing familiarity with guidelines, a positive perception of guidelines, awareness of poor guideline compliance, and assistance from specialist staff as facilitators of the uptake of guideline recommendations. Barriers existing within the prescribing environment such as the prescribing culture, a lack of time, and poor communication and coordination of therapeutic drug monitoring processes were identified as hindrances to guideline compliance.Conclusions: The provision of guidelines may not be sufficient in ensuring appropriate prescribing and monitoring of vancomycin when barriers relating to the prescribing environment exist. Developing interventions targeted toward these barriers, such as having dedicated phlebotomists for vancomycin blood sampling, fostering better handover processes, and educating staff on poorly understood aspects of guidelines, is likely to improve the uptake of guideline recommendations for vancomycin and other medications requiring therapeutic drug monitoring.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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