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Improving antibiotic use in hospitals: development of a digital antibiotic review tracking toolkit (DARTT) using the behaviour change wheel

Wojcik, Gosha; Ring, Nicola; Willis, Diane; Williams, Brian; Kydonaki, Kalliopi


Brian Williams


To develop a theory-informed behaviour change intervention to promote appropriate hospital antibiotic use, guided by the Medical Research Council’s complex interventions framework.

A phased approach was used, including triangulation of data from meta-ethnography and two qualitative studies. Central to intervention design was the generation of a robust theoretical basis using the Behaviour Change Wheel to identify relevant determinants of behaviour change and intervention components. Intervention content was guided by APEASE (Acceptability, Practicability, Effectiveness, Affordability, Side-effects, Equity) criteria and coded using a Behaviour Change Technique Taxonomy. Stakeholders were involved throughout.

From numerous modifiable prescribing behaviours identified, active ‘antibiotic time-out’ was selected as the target behaviour to help clinicians safely initiate antibiotic reassessment. Prescribers` capability, opportunity, and motivation were potential drivers for changing this behaviour. The design process resulted in the selection of 25 behaviour change techniques subsequently translated into intervention content. Integral to this work was the development and refinement of a Digital Antibiotic Review Tracking Toolkit.

This novel work demonstrates how the Behaviour Change Wheel can be used with the Medical Research Council framework to develop a theory-based behaviour change intervention targeting barriers to timely hospital antibiotic reassessment. Future research will evaluate the Antibiotic Toolkit’s feasibility and effectiveness.

Journal Article Type Article
Acceptance Date Feb 15, 2023
Online Publication Date Feb 28, 2023
Deposit Date Mar 1, 2023
Publicly Available Date Mar 1, 2023
Journal Psychology & Health
Print ISSN 0887-0446
Electronic ISSN 1476-8321
Publisher Routledge
Peer Reviewed Peer Reviewed
Pages 1-21
Keywords Antimicrobial resistance, Prescribing behaviour; Antibiotic time-out; Hospitals; Behaviour change wheel, Intervention development


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