Antibiotic Research in Care Homes (ARCH)

Principal Investigator	Dr Charis A Marwick, University of Dundee.
Co-Investigator	Dr Suzanne M Grant, University of Dundee. Dr Fabiana Lorencatto, University College London. Professor Bruce Guthrie, University of Edinburgh. Professor Peter T Donnan, University of Dundee. Professor Carmel Hughes, Queen's University Belfast.
Additional UCL team members	Dr Aleksandra Herbeć
Project start and end dates	01 October 2017 – 30 September 2021
Funder	Economic and Social Research Council, working in partnership with the Department of Health and the Arts & Humanities Research Council (AHRC), under Theme 4: Behaviour within and beyond the health care setting.
Project website	http://arch-antibiotics.org.uk/ @arch_antibiotic

Project aims

This multidisciplinary project has several aims. First, it aims to characterise antibiotic use as well as the factors that contribute to antibiotic use and prescribing in the care homes in Scotland. Second, it aims to identify and evaluate potential interventions to limit antibiotic use in this context.

Project details

Background
Antimicrobial Resistance (AMR) is a growing global public health challenge. Overuse of antibiotics, including using them when they are not needed, is a key contributor to AMR. Evidence points to the overuse of antibiotics in the care homes, and there is an agreement that antibiotic use can be safely reduced in this setting to help address ARM. This multi-disciplinary research programme aims to identify and preliminarily evaluate ways in which we can improve antibiotic prescribing and use in the care homes.

Methods
The project employs mixed-methods that draw on epidemiological (Work package 1), ethnographic (Work package 2) and behavioural science (Work Package 3) approaches to first identify potential intervention targets and then to develop and evaluate (Work Package 4) an intervention to improve antibiotic use in case homes in Scotland. Work Package 3 is led by a team at UCL Centre for Behaviour Change and involves applying Theoretical Domains Framework to design in-depth interviews and surveys to identify barriers and enablers among the care home staff, prescribers and pharmacists to a range of behaviours that contribute to antibiotic use.

Current results and implication
Data collection is ongoing. The findings will help inform future interventions that could be developed and implemented in the care home setting.

Next steps

We are in the process of collecting and analysing data from Work package 1, 2 and 3. Once completed, we will commence work on Work package 4.