3 Takeaways From VHAN’s Antibiotic Stewardship Learning Exchange

Last week, VHAN experts Jacky Bradley, PharmD, MBA and Sophie Katz, MD, facilitated a Learning Exchange for network members to share best practices and learn how to leverage the resources from VHAN’s new Antibiotic Stewardship Program.

Dr. Katz kicked off the session by defining antibiotic stewardship, the effort to measure and improve how antibiotics are prescribed by clinicians and used by patients. Bradley shared the effects of antibiotic overuse, which causes 56% of estimated emergency department visits for adverse drug events. These unnecessary visits reduce quality performance and increase the cost of care, totaling $19.1 million in excess national health care costs in 2017.

Other takeaways from the session include:

• How to talk to patients about antibiotic use. Dr. Katz shared the Dialogue Around Respiratory Illness Treatment model (DART) that teaches providers how to have productive conversations with patients around antibiotic use for upper respiratory infections (URI). She noted that it’s important to deliver a clear diagnosis of a viral infection and provide clear treatment recommendations. Clinicians should also focus on teaching patients that antibiotics won’t heal viral illnesses and they also carry some risks when prescribed.
• Antibiotic shortages. Several antibiotics are in short supply this year, likely due to high levels of respiratory illnesses such as flu and RSV. If a suspension antibiotic is unavailable, Dr. Katz noted that the American Academy of Pediatrics (AAP) suggests prescribing tablets, chew tabs or capsules, rounding the dose about 10 percent, and crushing the medication into applesauce for delivery. You can find the complete AAP guidelines here.
• New VHAN antibiotic stewardship resources. Appropriate treatment of URIs are quality measures on certain VHAN value-based contracts, including Aetna commercial. VHAN’s clinical team has developed pocket cards for adult and pediatric patients to help reduce unnecessary antibiotic prescriptions for URIs. And because some patients are disappointed to hear they won’t be prescribed an antibiotic for their condition, the pocket cards include helpful patient messaging to make those conversations easier. VHAN also developed educational office posters comparing viruses and bacteria, and an antibiotic stewardship case study to share best practices. All of these resources can be found on the VHAN Hub.