An Evaluation of the Impact of an OPEN Stewardship Generated Feedback Intervention on Antibiotic Prescribing among Primary Care Veterinarians in Canada and Israel
Kamal R. Acharya,
Adar Cohen,
Gabrielle Brankston,
Jean-Paul R. Soucy,
Anette Hulth,
Sonja Löfmark,
John S. Brownstein,
Nadav Davidovich,
Moriah E. Ellen,
David N. Fisman,
Jacob Moran-Gilad,
Amir Steinman,
Derek R. MacFadden,
Amy L. Greer
Affiliations
Kamal R. Acharya
Department of Population Medicine, University of Guelph, Guelph, ON N1G 2W1, Canada
Adar Cohen
Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 7610001, Israel
Gabrielle Brankston
Department of Population Medicine, University of Guelph, Guelph, ON N1G 2W1, Canada
Jean-Paul R. Soucy
Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
Anette Hulth
Public Health Agency of Sweden, 171 82 Stockholm, Sweden
Sonja Löfmark
Public Health Agency of Sweden, 171 82 Stockholm, Sweden
John S. Brownstein
Computational Epidemiology Lab, Boston Children’s Hospital, Boston, MA 02115, USA
Nadav Davidovich
School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel
Moriah E. Ellen
Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel
David N. Fisman
Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
Jacob Moran-Gilad
School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel
Amir Steinman
Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 7610001, Israel
Derek R. MacFadden
Ottawa Hospital Research Institute, Ottawa, ON K1Y 4E9, Canada
Amy L. Greer
Department of Population Medicine, University of Guelph, Guelph, ON N1G 2W1, Canada
An interrupted time-series study design was implemented to evaluate the impact of antibiotic stewardship interventions on antibiotic prescribing among veterinarians. A total of 41 veterinarians were enrolled in Canada and Israel and their prescribing data between 2019 and 2021 were obtained. As an intervention, veterinarians periodically received three feedback reports comprising feedback on the participants’ antibiotic prescribing and prescribing guidelines. A change in the level and trend of antibiotic prescribing after the administration of the intervention was compared using a multi-level generalized linear mixed-effect negative-binomial model. After the receipt of the first (incidence rate ratios [IRR] = 0.88; 95% confidence interval (CI): 0.79, 0.98), and second (IRR = 0.85; 95% CI: 0.75, 0.97) feedback reports, there was a reduced prescribing rate of total antibiotic when other parameters were held constant. This decline was more pronounced among Israeli veterinarians compared to Canadian veterinarians. When other parameters were held constant, the prescribing of critical antibiotics by Canadian veterinarians decreased by a factor of 0.39 compared to that of Israeli veterinarians. Evidently, antibiotic stewardship interventions can improve antibiotic prescribing in a veterinary setting. The strategy to sustain the effect of feedback reports and the determinants of differences between the two cohorts should be further explored.
