Researchers at University of Chicago Medicine have created an antibiotic stewardship training program for internal medicine residents that incorporates social media platforms, offering a technological tool for a growing health problem.
Changing the way doctors prescribe antibiotics is a cornerstone in the fight against antibiotic resistance and will require new approaches to cut the number of unnecessary prescriptions. Now, a team of researchers have found that social media platforms can be a valuable tool in antibiotic stewardship programs.
The need to implement more judicious antibiotic prescribing practices has grown in the medical community. New research published earlier this year, conducted by the Centers for Disease Control and Prevention and the Pew Charitable Trusts, showed that 20% to 50% of antibiotics prescribed in acute-care hospitals in the United States are administered unnecessarily. The White House’s National Action Plan to Combat Antibiotic Resistance calls for a 50% reduction in inappropriate antibiotic prescriptions by 2020, supporting studies for improved use, a practice known as antibiotic stewardship.
Cutting back on antibiotic overuse will help our healthcare system reduce the number of antibiotic-resistant infections caused by bacterial superbugs that are growing increasingly immune to current drug treatments, as well as to reduce the number of in-hospital death rates from such infections. While the core elements of antibiotic stewardship programs rely on leadership, drug expertise, education, tracking, and reporting, there’s room for new approaches when hospitals create programs to cut back on overprescribing.
In a recent study, a team of researchers at University of Chicago Medicine looked into ways of incorporating social media platforms into stewardship. Their paper studied how Facebook and Twitter could be used when training internal medicine residents — in an age demographic that frequently uses the platforms and mobile devices – on antibiotic education and prescribing practices, and was recently published in the American Journal of Infection Control. “Education of primary prescribers is an essential part of antimicrobial stewardship to promote optimal use of antimicrobials,” write the authors in their paper, noting the educational benefits of technology already in use in medical practices. “The use of innovative strategies for health care provider education regarding antibiotic use is needed to supplement teaching beyond the lecture hall and the medical wards.”
To study the potential impact of antibiotic stewardship training using Facebook and Twitter, the researchers engaged internal medicine residents to take part in a stewardship program by following accounts set up through the platforms. The investigation took place from August 2013 to January 2014, with 55 internal medicine residents taking part. While the program was not mandatory, residents were encouraged to engage with the social media content through their personal accounts. The content was designed to distribute educational information regarding antibiotic prescribing, resistance, and stewardship tools available to doctors and hospital staff. Residents received daily medical trivia contests through Facebook and Twitter for an average of five days each week, with gift cards as incentive rewards for participating and answering questions correctly.
“The best educational tools are going to be the ones that allow you to reach providers and trainees most effectively,” says study author Jennifer Pisano, MD, of the inspiration behind the investigation. “Social media is just one way that we may be able to deliver education on antimicrobial stewardship, updates in pathways, and bridge that gap.”
Of the residents taking part in the study, 71% completed surveys conducted before and after the research period. In their responses, 90% noted that knowledge of antibiotic use would benefit their future medical work and 98% believed that antibiotic resistance is a serious problem in healthcare. Another 89% of residents surveyed signaled that antibiotics are overused in general and 52% thought antibiotics are overused at their medical institution, but only 38% believed that they, themselves, overused antibiotics. Overall awareness of the hospital’s antibiotic stewardship program, clinical pathways, and best dosage practices went up.
The study offered insight into how internal medicine residents learn about antibiotic use, and residents participating in the study noted getting much of their information on antibiotic use from other people such as infectious disease fellows, other residents, and attending physicians, and that these were the people they turned to with their questions on antibiotic use.
“This was important to learn because it underscores the need to educate about stewardship principles at all levels of training, with continuous reinforcement to ensure that the information being taught is correct and timely, considering guidelines and epidemiologic data are updated frequently,” note the authors. “As technology becomes more widely used in medical care, social media—based education could be even more successful than in our cohort. We believe social media has the capacity to reach medical trainees to disseminate and reinforce important information regarding antibiotic use criteria and other educational and patient safety tools, including the use of order sets and pathways in a uniquely, timely, far-reaching fashion and at the point of care.”