ePrescribing-based Antimicrobial Stewardship
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Work Package 1

Planning, developing and optimising all elements of the complex ePAMS+ intervention, and carrying out qualitative feasibility and process studies of the implementation of ePAMS+


We seek to:

  • Carry out theory-, evidence- and person-based intervention planning to identify the necessary components and characteristics of ePAMS+
  • Carry out qualitative investigations and feasibility studies to inform development and optimisation of ePAMS+
  • Iteratively develop and optimise ePAMS+, drawing on the qualitative feasibility work
  • Carry out qualitative process analyses across trial sites to understand mechanisms of action, unintended consequences and likely generalisability and sustainability of ePAMS+


We will undertake systematic theory-, evidence- and person-based intervention planning to underpin the development of ePAMS+, drawing on our conceptual overview and systematic review; our implementation and evaluation experience; discussions with NHS staff, patients, vendors and international experts; and findings emerging from the ARK  programme grant for applied research (http://www.arkstudy.ox.ac.uk/). The person-based element of the approach involves: a) collating information from a variety of sources (mainly qualitative and quantitative research and PPI input) about the perspective and context of all intervention users (hospital staff and patients); identifying (with PPI input) the key issues and barriers that need to be addressed to ensure that the intervention is maximally acceptable, feasible and engaging for all users; and c) optimising all elements of the intervention through iterative qualitative research to gain detailed feedback from a large number of users and modify the intervention to address all problems this process reveals. This approach is combined with a detailed behavioural analysis based on theory and evidence, which informs the selection of intervention ingredients most likely to be effective.

We will supplement the existing evidence base with primary qualitative research to understand user needs and will employ behavioural analysis to identify the behaviour change techniques and intervention design characteristics required to ensure that all elements of the intervention are appropriate, engaging and effective. We will iteratively elicit clinician and patient views of intervention elements and prototypes (in WP1b) in order to inform optimisation of acceptability and feasibility (in WP1a). Next we will carry out qualitative studies in parallel with the feasibility trials (WP2) to confirm acceptability and feasibility and inform any final modifications to the intervention prior to WP3, and finally we will carry out a qualitative process study in parallel with WP3 to explain mechanisms of action and trial outcomes.


For further information contact Professor Robin Williams (r.williams@ed.ac.uk)