Next time you have a raging toothache imagine a world without antibiotics. We’re not talking about the 1940s, we’re possibly talking about the 2040s. Antibiotic resistance, the process whereby bacteria evolve mechanisms to counteract the effects of antibiotics, is a growing problem.
In order to slow down the development of antibiotic resistance, we need to reduce the number of antibiotic prescriptions. It sounds easy, but changing any behaviour is difficult, let alone a really complex behaviour like antibiotic prescribing. Complex issues like this require us to think differently about how we go about doing the research.
With the help of ESRC funding, we have put together a collaborative team with a range of backgrounds: data-scientists, health-psychologists, social scientists, designers and healthcare providers. Using their expertise we hope to approach the problem from different perspectives and integrate this knowledge to develop interventions to improve how antibiotics are used across different healthcare settings.
The research, is divided into 3 interlinked work-packages across five settings: primary care, secondary care, community, community pharmacies and care homes.
Work-package 1: Better information for intervention design. Understanding who gets antibiotics and when is critical for targeting interventions to optimise prescribing. High-quality information on prescribing patterns and outcomes across healthcare settings in the UK is lacking. Using existing electronic datasets we will quantify patterns of antibiotic use in general practice, nursing homes and hospitals. We will set up an online survey (the Bug Watch survey) to help us understand antibiotic seeking behaviour in the general public. This information will provide insight into where problems lie, and thus where we might focus our efforts in later work-packages.
Key people: Dr Laura Shallcross, Dr Catherine Smith, Dr Peter Dutey-Magni, Ms Ellen Fragaszy, Mr Haydn Williams, Dr Martin Gill, Dr Anne Connolly
Work-package 2: Behavioural diagnosis. An in-depth understanding of prescribing is essential to inform effective intervention development. We will use insights from behavioural-, and social- science to identify potential interventions. Work will include: interviews with healthcare workers and members of the public to identify drivers of antibiotic prescribing and antibiotic seeking, a review of published papers that describe interventions targeting antibiotic use, and observations of healthcare worker practice.
Key people: Dr Carolyn Tarrant, Dr Fabiana Lorencatto, Dr Elise Crayton, Ms Gill Forbes, Dr Emma Richardson, Dr Michelle Richardson, Ms Roberta Roccella
Work-package 3: Co-production and dissemination of intervention bundles. We will design a range of interventions that target the influences on prescribing identified in previous work-packages. We will engage with healthcare workers and members of the public to assess the suitability of potential interventions. We will then use principles of user-centred design to develop these ideas further and work with designers to develop online resources for the public, practitioners and those planning stewardship programmes.
Key people: Mr Jonathan West, Dr Rosie Traina
- Andrew Hayward - UCL
- Susan Michie - UCL
- Laura Shallcross- UCL
- Lou Atkins- UCL
- Jonathan West – Royal College of Arts
- Jenny Mindell- UCL
- Michelle Richardson- UCL
- Fabiana Lorencatto- UCL
- Ellen Fragaszy- UCL
- Anne Connolly - NatCen
- Rob Horne- UCL
- James Thomas- UCL
- Carolyn Tarrant- University of Leicester
- Nick Freemantle- UCL
- Martin Gill –University Hospitals Birmingham NHS Foundation Trust
- Patty Kostkova- UCL
- John Robson – Queen Mary University London
- Claire Royston – Four Seasons Health Care
- Catherine Smith- UCL
- Patrick Rockenschaub- UCL
- Peter Dutey-Magni- UCL
- Chris Fuller- UCL
- Nadia Elsay- UCL
- Emma Richardson – University of Leicester
- Elise Crayton - UCL
- Gill Forbes – UCL
- Rosie Traina - RCA
Timeline: Autumn 2017-Summer 2020
Opportunities for work experience/research projects
If you have a Soc-B PhD studentship and are interested in a 3-month placement working on an area related to antimicrobial resistance we would be pleased to hear from you. Please contact Laura Shallcross for more information.
Lead, work-package 1: Dr Laura Shallcross
PASS study administrator: Ms Nadia Elsay
PASS project manager: Mr Chris Fuller
Follow us on twitter: @PASS_antibiotics