Program Profile

Antibiotic Stewardship Improvement Initiative at a Veterans Health Administration Ambulatory Care Center

Author and Disclosure Information

 

References

The pamphlet Viral Illness Support Pack Traffic Light Card (eAppendix available online at doi:10.12788/fp.0302) provides important clinical information to the patients about their illness. Patients are instructed to contact their primary care team if they are worse after 3 days of illness; symptoms are not improving after 10 days; or they experience blood in respiratory secretions, chills or generalized aching, and localized pain that is one-sided or significantly worsening. Patients are clearly informed to seek further care if not improving with symptomatic treatment.

The ability to provide patients with symptomatic relief, including throat lozenges, lip balm, and acetaminophen, was felt to be important in the success of the project. Furthermore, this eliminated an extra step of the patient needing to visit the pharmacy.

Limitations

Limitations of the study included starting distribution of the support packs somewhat after the onset of the viral illness season, failure to reach all prescribers for academic detailing at the start of the program, and several instances of temporary unavailability of the support packs in some areas.

Conclusions

Patients with ARIs are often significantly symptomatic and frequently believe that they require an antibiotic for treatment. Clinicians may adjust their behavior in response to their patients’ expectations, stated or unstated. The results of this project demonstrate that the combination of patient education and the ready availability of a nonantibiotic symptomatic treatment option can significantly decrease the unnecessary prescribing of antibiotics for viral illnesses.

Acknowledgments

The authors are grateful to Ms. Traci Washington for assistance in sourcing materials; to Karen Corr, PhD, and Anthony Restuccio, MD, for advice on methods; to Mr. Daniel Pignatelli for assistance with data interpretation; and to Mr. Keith Skidmore, Ms. Crystal Conley, and Ms. Megan Harris for assistance with assembling the Viral Illness Support Packs.

Pages

Recommended Reading

Hospital factors drive many discharges against medical advice
Federal Practitioner
TAVI device shows less deterioration than surgery 5 years out
Federal Practitioner
Surgery handoffs still a risky juncture in care – but increasing communication can help
Federal Practitioner
Hospital medicine gains popularity among newly minted physicians
Federal Practitioner
FDA: Urgent device correction, recall for Philips ventilator
Federal Practitioner
New guideline for in-hospital care of diabetes says use CGMs
Federal Practitioner
Registered Dietitian Nutritionists’ Role in Hospital in Home
Federal Practitioner
Effect of Pharmacist Interventions on Hospital Readmissions for Home-Based Primary Care Veterans
Federal Practitioner
Hospital-acquired pneumonia is killing patients, yet there is a simple way to stop it
Federal Practitioner
Establishing a Hospital Artificial Intelligence Committee to Improve Patient Care
Federal Practitioner