Kiri

* Obligatoria

International survey on Antimicrobial Stewardship Programs in Primary Care Background of the survey

The survey is conducted under the European Joint Action on Antimicrobial Resistance and Healthcare-Associated Infections 2 (EU-JAMRAI-2), specifically in Work Package 6 (WP6). This WP focuses on Antimicrobial Stewardship (AMS) in humans, animals, and the environment. With the overall objective to make Europe a best practice region and to support the development and implementation of core elements and core competencies on AMS, task 6.1 addresses AMS in human health. One of the main goals of this activity is to provide a common European framework on AMS in the human field. This is a set of three surveys on the Antimicrobial Stewardship Programmes (ASP). Each of them will focus on a level of care: hospital, primary care and long-term care facilities.

This survey refers to Primary Care

According to the World Health Organization (2008). Primary Health Care: Now More Than Ever. Geneva: World Health Organization: “Primary health care is essential health care that is universally accessible to individuals and families in the community, provided by health professionals who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community.”

For this survey, the following definition will serve for clarification: Primary care refers to health care provided by a medical professional (such as a general practitioner, pediatrician, or nurse) with whom a patient has initial contact and by whom the patient may be referred to a specialist.

It is important to note that, for this survey, the term "Primary Care" excludes long-term care facilities, such as nursing homes, even if these are integrated with or closely linked to primary care services in some contexts.

Additionally, through the survey, the term "Primary Care Reference Area/Organizational Unit" will be used. This should be understood as the geographical areas or regions where primary care services are organized and delivered. These areas include healthcare centres or facilities responsible for providing primary care to the designated population or citizens. The structure ensures that primary care services are accessible within the community and aligned with local healthcare needs.

Aim of the survey: To identify the core elements and core competencies for primary care AMS across Europe.

Target sources of information to complete the survey: National Action Plans (NAP) on Antimicrobial Resistance (AMR), equivalent National Strategies, Programmes, or other institutional documents not developed under AMR NAPs or strategies. These are guidance frameworks developed by governments’ official institutions or health authorities to address the challenges of AMR. NAPs are an essential element in the fight against AMR and should encompass key elements promoting the optimal use of antimicrobials by encouraging the development and implementation of Antimicrobial Stewardship Programmes (ASPs) in the human healthcare field. The results of this survey will be used to identify common and differing elements as an initial step for developing a common framework for Primary Care ASP in European countries. Subsequently, the global relevance and feasibility will be evaluated, followed by a structured consensus procedure to select common core elements and competencies for Primary Care.

Practical instructions: Please complete this survey by Monday 9th December. Your responses will help us prepare for the WP6 T6.1 Antimicrobial Stewardship in humans Workshop focused on Primary Care. Note that for clarification purposes you will find a glossary at the beginning of the page and explanatory notes (*) under cer- tain questions. Please refer any questions related to this survey to: [email protected] 

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INSTITUTION CONTACT INFORMATION

Full Name * 1.

Country * 2.

Escriba una dirección de correo electrónico

Contact details (email address) * 3.

Academic qualification * 4.

Current role * 5.

Name of the Institution represented * 6.

Name of institution/health authority that coordinates the NAP * 7.

If you don’t work in the institution/health authority that coordinates the NAP, indicate your position in relation with the coordination of the NAP *

8.

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General information regarding your National Action Plan on AMR (AMR- NAP). Glossary on this section:

AMR: Antimicrobial resistance AMS: Antimicrobial stewardship ASP: Antimicrobial Stewardship Programmes HCP: Healthcare professionals NAP: National Action Plan

Yes

No

I don’t know/unclear in documentation

Does your country have a NAP or equivalent National Strategies or Programmes with specific information regarding Primary Care core AMS elements? *

9.

If your NAP guidance document or equivalent National Strategy or Programme is not publicly available, please provide the latest version of the official documents (PDF version or other…) to [email protected]

If your NAP guidance document or equivalent National Strategy or Programme is publicly available, please provide an URL *

10.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes include provisions to encourage financial support for Primary Care ASP activities (e.g., funding for salaries, training, etc.)? *

11.

Yes

No

I don’t know/unclear in documentation

(*) By professional group (pharmacists, microbiologists, primary care physicians, paediatricians, epidemiologists, etc), and/or speciality (surgery, preventive, etc)

Does your NAP, government official institution or health authority develop a set of professional competencies for healthcare professionals (HCP) (*) on Primary Care ASP? *

12.

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If the guidance document is not publicly available, please provide the latest version of the official documents (PDF version or other…) to [email protected]

If your NAP, government official institution or health authority has a guidance document of professional competencies for HCP on Primary Care ASP and is publicly available, please provide URL *

13.

Yes

No

I don’t know/unclear in documentation

(*) A reference indicator is used to evaluate various aspects of antimicrobial use and its impact (structure, process and/or outcome indicators). These indicators help in tracking progress, identifying areas for improvement, and ensuring optimal use of antimicrobials.

Does your NAP or other government official institution have a set of reference indicators (*) for Primary Care ASP assessment publicly available (e. g. antimicrobial consumption, microbiological data, clinical outcomes, process indicators)? *

14.

If they are not publicly available, please provide the latest version of the documents (PDF version or other…) to [email protected]

If your NAP or government official institution has developed Primary Care AMS indicators, please provide links to the latest versions *

15.

Yes

No

I don’t know

Does your NAP or other government official institution have reference national guidelines for the management of the most common infectious diseases in the community? *

16.

If they are not publicly available, please provide the latest version of the documents (PDF version or other…) to [email protected]

If your NAP or government official institution has reference national guidelines for the management of the most common infectious diseases in the community and is publicly available, please provide URL *

17.

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SURVEY INFORMATION REGARDING PRIMARY CARE ANTIMICROBIAL STEWARDSHIP PROGRAMMES (ASP) in your National Action Plans on Antimicrobial Resistance or equivalent National Strategies or Programmes.

This survey is divided into 6 domains:

DOMAIN 1. GOVERNANCE OF THE ASP: PRIMARY CARE LEADERSHIP COMMITMENT

DOMAIN 2. HUMAN AND TECHNICAL RESOURCES DOMAIN

DOMAIN  3. ACTIONS: INTERVENTIONS TO OPTIMISE ANTIMICROBIAL USE DOMAIN

DOMAIN  4. EDUCATION, PRACTICAL TRAINING, COMPETENCE DEVELOPMENT AND COMMUNICATION DOMAIN

DOMAIN  5. RESULT ANALYSIS AND REPORTING DOMAIN

DOMAIN  6. EVALUATION OF IMPLEMENTATION AND ACCREDITATION/ CERTIFICATION

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DOMAIN 1. Governance of the ASP: Primary Care Leadership Commitment Refers to the institutional support for the ASP by the Primary Care management or institution management (local/regional le- vel)

Glossary on this section: AMS: Antimicrobial stewardship ASP: Antimicrobial stewardship programmes GP: General Practitioner HCP: Healthcare professionals NAP: National Action Plan

Yes

No

I don’t know/unclear in documentation

Does the NAP or equivalent National Strategies or Programmes recommend that each Primary Care reference area or organizational unit have its own specific antimicrobial stewardship team? *

18.

Regional

Provincial

Network level (collaborative groups of healthcare providers (e.g., GPs, clinics, allied HCP) within a specific area working together to deliver coordinated care)

Facility level (individual healthcare facilities within the primary care setting, such as a specific clinic, health centre (excluding nursing homes)

Practice level (individual medical practices, such as a group of GPs working together within a practice or a single HCP practice setting)

Unknown

Otras

At which level are these teams recommended to be established * 19.

Yes

No

I don’t know/unclear in documentation

(*) understood as the national/regional/local health service -whichever the case is at your country- in charge of Primary Care

Does your NAP or equivalent National Strategies or Programmes recommend that Primary Care management to formally commit to the ASP and prioritize it as a key programme within the institution(*)? *

20.

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Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend appointing and involving a member of the Primary Care management team to ensure the ASP has sufficient resources and support to accomplish its mission? *

21.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend embedding the ASP to an organizational multidisciplinary structure responsible for AMS in the Primary Care *

22.

Committee focused on appropriate use of antimicrobials

Pharmacy committee

Patient safety committee

Care quality committee

Otras

This structure is a * 23.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend Primary Care reference areas or organisational units to facilitate leadership, engagement and accountability for AMS interventions by providing AMS team members dedicated time to manage the programme and conduct interventions? *

24.

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Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend the inclusion of budgeted financial support for AMS activities in Primary Care at national level (e.g. support for salary, training, rapid diagnostic tools, clinical support systems, etc.)? *

25.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend that Primary Care reference areas or organizational units should have a structured local ASP framework tailored to local context and needs? *

26.

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DOMAIN 2. HUMAN AND TECHNICAL RESOURCES According to WHO policy guidance on integrated antimicrobial stewardship activities. Geneva: World Health Organization; 2021. (https://www.who.int/publications/i/item/9789240025530) the ability to carry out quality AMS depends on the availabi- lity of adequate resources: trained personnel with time allocated to AMS, surveillance systems to provide data about antimi- crobial consumption, microbiological data, clinical outcomes, safety issues, etc., and the integration of this information into data analysis systems. 

Glossary on this section: AMS: Antimicrobial stewardship ASP: Antimicrobial stewardship programme HCP: Healthcare professionals NAP: National Action Plan

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes define the core composition, roles and responsibilities of a Primary Care AMS multidisciplinary team trained and experienced in infectious diseases? *

27.

Primary care physician with experience in infectious diseases and antimicrobial resistance

Primary care paediatrician with experience in infectious diseases and antimicrobial resistance

Primary care pharmacist with experience in infectious diseases and antimicrobial resistance

Microbiologist with experience in Primary Care

Nurse with experience in infectious diseases and antimicrobial resistance

Emergency physician with experience in infectious diseases and antimicrobial resistance

Epidemiologist with experience in infectious diseases and antimicrobial resistance

Otras

List the professional profile that constitutes the core team composition (multiple answers) * 28.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend appointing a leader for the core Primary Care AMS team, responsible for the ASP management and AMS activities? *

29.

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Primary care physician with experience in infectious diseases and antimicrobial resistance

Primary care paediatrician with experience in infectious diseases and antimicrobial resistance

Primary care pharmacist with experience in infectious diseases and antimicrobial resistance

Microbiologist with experience in Primary Care

Nurse with experience in infectious diseases and antimicrobial resistance

Emergency physician with experience in infectious diseases and antimicrobial resistance

Epidemiologist with experience in infectious diseases and antimicrobial resistance

Otras

Identify the professional profile proposed as the leader for the AMS teams (multiple answers) *

30.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes define or recommend  measuring the weekly or monthly dedication (number of hours per week or month) that Primary Care AMS team members spend on AMS-specific activities? *

31.

Primary care physician with experience in infectious diseases and antimicrobial resistance

Primary care paediatrician with experience in infectious diseases and antimicrobial resistance

Primary care pharmacist with experience in infectious diseases and antimicrobial resistance

Microbiologist with experience in primary care

Nurse with experience in infectious diseases and antimicrobial resistance

Emergency physician with experience in infectious diseases and antimicrobial resistance

Epidemiologist with expertise in infectious diseases and antimicrobial resistance

Otras

Indicate the dedication of which AMS team members are measured (multiple answers) * 32.

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Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend Primary Care reference areas or organizational unit regularly updated guidance for AMS based on/according to new evidence and local susceptibility for specific syndromes? *

33.

There is a national reference guidance that can be adapted or adopted by Primary Care Areas/Centres

There is not national reference guidance. NAP recommends Primary Care Areas to develop a local guideline.

Which of these apply * 34.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend Primary Care reference areas or organizational units to establish  standardized procedures for defining the inclusion/exclusion of antimicrobials in the antimicrobial formularies (e.g. a list of antimicrobials available in the Primary Care Centres and emergency rooms)? *

35.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend Primary Care HCP to have timely access to diagnostic results to support the management of the most common infections in the community? *

36.

Imaging services

Microbiological results

Biochemistry and Clinical Analysis Lab results

Rapid Diagnostic Tests for Infectious Diseases

Otras

Timely access available for (multiple answers) * 37.

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Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend that reference microbiology laboratories provide Primary Care HCP and management antimicrobial susceptibility data for a range of key bacteria that cause infections in the community (local sensibility maps) *

38.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend that institutions provide tools to routinely monitor the quantity of antimicrobial prescribing in the community? *

39.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend that institutions provide tools to routinely monitor the quality of antimicrobial prescribing in the community? *

40.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend that institutions provide e-prescribing tools to facilitate delayed prescription of antibiotics by Primary Care prescribers? *

41.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend Primary Care reference areas or organizational units have electronic medical records to document patient clinical data, indications for antimicrobial prescriptions, and description of prescribed antimicrobial treatments (e.g., dose, duration…)? *

42.

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Sociodemographic data

Clinical conditions

Medication prescriptions (indication, name of the drug, dosage, duration, route and interval of administration)

Vaccination data

Hospital care visits, admissions

Microbiological data

Biochemistry and Clinical Analysis Lab

Otras

It includes (multiple answers) * 43.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend Primary Care HCP to have timely access to the clinical information of patients? *

44.

Microbiological data

Antimicrobial treatments

Biochemistry and Clinical Analysis Lab results

Image results

Antimicrobial test allergies

Prescriptions from Primary care and hospitals

Please select (multiple answers) * 45.

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DOMAIN 3. ACTIONS: INTERVENTIONS TO OPTIMISE ANTIMICROBIAL USE These refer to the activities, interventions or practices developed to improve the appropriate use of antimicrobials.

Glossary on this section: AMS: Antimicrobial stewardship CDI: Clostridioides difficile infection CDSS: Clinical decision support systems  HCAI: Healthcare associate infections HCP: Healthcare professionals NAP: National Action Plan UTI: Urinary tract infection

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend Primary Care reference areas or organizational units to annually provide local resistance data for updating antimicrobial treatment guidelines? *

46.

Yes

No

I don’t know/unclear in documentation

(*) CDSSs are considered to be tools to support diagnostic or therapeutic decision-making by providing information about a given clinical context, patient characteristics and access to up-to-date clinical practice guidelines (CPGs) among others at the point of care

Does your NAP or equivalent National Strategies or Programmes recommend the use of computerized/automated tools to support reporting, diagnostic or therapeutic decision (e.g., clinical decision support systems CDSSs (*) for Primary Care prescribers, such as e-prescribing guides and prescription alerts? *

47.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend the use of specific support programmes to ensure the audit of antimicrobial treatment courses for the optimal use of specific antimicrobials in Primary Care? *

48.

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Antibiotics with high environmental risk

Antibiotics with high economic impact

Prolonged use of antibiotics duration

Otras

Please indicate which antimicrobials (multiple answers): * 49.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend the use of specific support programmes to ensure the audit of clinical management of antimicrobial treatment in specific severe conditions treated in Primary Care? *

50.

Pneumonia

Complicated UTI, pyelonephritis

Multi-resistant infections

Clostridioides difficile infection (CDI)

Otras

Please indicate in which specific conditions (multiple answers) * 51.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend the AMS team to perform routinely antimicrobial post-prescription audits and provide feedback to prescribers?  *

52.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend that each Primary Care reference area or organizational unit have a specific healthcare-associated infection prevention and control (HCAI) team? *

53.

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Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend establishing coordination between AMS and HCAIs responsible individuals in Primary Care? *

54.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend establishing specific coordination between Primary Care and hospital AMS teams for the management of patients with infectious diseases to ensure continuity of care? *

55.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend the implementation of ASP interventions in nursing homes carried out by Primary Care HCP? *

56.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend establishing a specific coordination strategy in AMS between the Primary Care reference area and community pharmacies to improve the management of infectious diseases in the community? *

57.

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DOMAIN 4. EDUCATION, PRACTICAL TRAINING, COMPETENCE DEVELOP- MENT AND COMMUNICATION According to Antimicrobial stewardship programmes in health-care facilities in low- and middle-income countries. A practical toolkit. Geneva: World Health Organization; 2019 (https://www.who.int/publications/i/item/9789241515481) educational pro- grammes play a crucial role in providing and updating knowledge, particularly in the context of ASP. These programmes re- quire careful planning and development of training activities. Additionally, they should be integrated into daily practice.

HCP involved in AMS activities should acquire specific competencies. ASP should facilitate access and support for training on optimized antibiotic use. This could include basic and continuous education of clinical staff, clinical case discussions, classes and regular sharing of information, reminders and AMS e-learning resources.

Resources need to be allocated to support educational workshops and training programmes on AMS with educational mate- rial and a compilation of e-learning AMS resources.

Glossary on this section: AMS: Antimicrobial stewardship AMR: Antimicrobial resistance ASP: Antimicrobial stewardship programmes HCP: Healthcare professionals NAP: National Aaction Plan

Yes

No

I don’t know/unclear in documentation

Does your NAP, governments’ official institutions or health authorities recommend establishing a competency framework that outlines the necessary skills and qualifications for Primary Care AMS team members? *

58.

Primary care physician with expertise in infectious diseases and antimicrobial resistance

Primary care paediatrician with expertise in infectious diseases and antimicrobial resistance

Primary care pharmacist with expertise in infectious diseases and antimicrobial resistance

Microbiologist with expertise in infectious diseases and antimicrobial resistance

Nurse with expertise in infectious diseases and antimicrobial resistance

Emergency physician with expertise in infectious diseases and antimicrobial resistance

Otras

If yes, which members of the Primary Care AMS team have a defined national competency framework? *

59.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes offer national training programmes or a series of educational resources for professionals on how to optimize antimicrobial prescribing in Primary Care? *

60.

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Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend as a Primary Care objective the need for professionals to receive regular training in antimicrobial prescribing and stewardship? *

61.

For AMS team members

For medical prescribers

For all prescribers

For all HCP (physicians, pharmacists, microbiologists, nurses, etc.)

Otras

If yes, for which professionals are recommended to receive regular training in antimicrobial prescribing and stewardship? (multiple answers) *

62.

Yes, but only for physicians

Yes, for all prescribers (no other HCP)

Yes, for physicians, microbiologists, nurses, and pharmacists.

Others

No

I don’t know/unclear in documentation

(*) It refers to a qualified physician (one who holds the degree of MD, DO, MBBS/MBChB), veterinarian (DVM/VMD, BVSc/BVMS), dentist (DDS or DMD), podiatrist (DPM) or pharmacist (PharmD) who practices medicine, veterinary medicine, dentistry, podiatry, or clinical pharmacy, respectively, usually in a hospital or clinic, under the direct or indirect supervision of a senior medical clinician registered in that specialty such as an attending physician or consultant.

Does your NAP or equivalent National Strategies or Programmes recommend AMS training activities to develop AMS competencies in Primary Care specialty trainee residents'/postgraduate (*) training curricula? *

63.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend peer-to- peer consultancies as a key Primary Care AMS intervention? *

64.

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Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend Primary Care reference areas or organizational units to improve awareness and understanding of AMR through effective communication and implementing AMS interventions among the population? *

65.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend Primary Care reference areas or organizational units to ensure effective communication with patients and prescribers regarding appropriate antimicrobial use and managing patient expectations? *

66.

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DOMAIN 5. RESULT ANALYSIS AND REPORTING A comprehensive analysis of the results of the ASP is needed to identify areas for improvement, target populations, and trends. This will help in planning for future actions. Sharing reports on both the AMS activities, interventions and the results obtained from this practice with professionals and managers has been shown to be an effective tool for improvement.

Glossary on this section: ASP: Antimicrobial stewardship programmes NAP: National Action Plan

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes have a set of reference national key indicators to monitor the results of the Primary Care ASP? *

67.

Antimicrobial consumption indicators

Microbiology indicators

Clinical outcome indicators

Process indicators

Otras

Indicate which key indicators are developed (multiple answers): * 68.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend reporting the results of the indicators  to the Primary Care professionals, ASP teams and management? *

69.

National

Regional

Primary Care Area or Unit

Otras

Antimicrobial consumption indicators

If yes, indicate level of disaggregation per indicator (national/regional/primary care reference area)

70.

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National

Regional

Primary Care Area or Unit

Otras

Microbiology indicators

If yes, indicate level of disaggregation per indicator (national/regional/primary care reference area)

71.

National

Regional

Primary Care Area or Unit

Otras

Clinical outcome indicators (e.g: decrease in the number of consultations for infectious diseases, decrease in hospital admissions for conditions managed in the community)

If yes, indicate level of disaggregation per indicator (national/regional/primary care reference area)

72.

National

Regional

Hospital

Otras

Process indicators (e.g: number of training activities carried out; number of consultancies, number of hours dedicated by AMS team, consultancies, etc.)

If yes, indicate level of disaggregation per indicator (national/regional/primary care reference area)

73.

Annually

Bi-annually

Quarterly

Monthly

Antimicrobial consumption indicators

If yes, indicate minimum periodicity your NAP or equivalent National Strategies or programmes recommend per indicator (annually/bi-annually/quarterly/monthly):

74.

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Annually

Bi-annually

Quarterly

Monthly

Otras

Microbiology indicators

If yes, indicate minimum periodicity your NAP or equivalent National Strategies or programmes recommend per indicator (annually/bi-annually/quarterly/monthly):

75.

Annually

Bi-annually

Quarterly

Monthly

Otras

Clinical outcome indicators (e.g: decrease in the number of consultations for infectious diseases, decrease in hospital admissions for conditions managed in the community)

If yes, indicate minimum periodicity your NAP or equivalent National Strategies or programmes recommend per indicator (annually/bi-annually/quarterly/monthly):

76.

Annually

Bi-annually

Quarterly

Monthly

Otras

Process indicators (e.g: number of training activities carried out; number of consultancies, number of hours dedicated by AMS team)

If yes, indicate minimum periodicity your NAP or equivalent National Strategies or programmes recommend per indicator (annually/bi-annually/quarterly/monthly):

77.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend documenting the indication for the prescribed antibiotic to monitor the adherence/compliance with community reference guidelines? *

78.

13/11/24, 9:27 International survey on Antimicrobial Stewardship Programs in Primary Care

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DOMAIN 6. EVALUATION OF IMPLEMENTATION AND ACCREDITATION/CERTIFICATION AMS is an integral component of health systems and assessing the implementation of ASP is crucial for ensuring quality care.

Glossary on this section: AMS: Antimicrobial stewardship ASP: Antimicrobial stewardship programmes NAP: National Action Plan

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes define which quality standards are considered minimum for a good Primary Care ASP? *

79.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend a specific guidance on ASP implementation process in Primary Care? *

80.

Yes

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend an assessment procedure for this implementation? *

81.

Yes, but only for prescribers

Yes, but only for ASP teams

Yes, but only for Centres (Primary Care facilities)

Yes, all the above

No

I don’t know/unclear in documentation

Does your NAP or equivalent National Strategies or Programmes recommend an accreditation/certification system in good AMS practices in Primary Care? *

82.

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Food for thought

From the questions above, which three core elements would be essential for your country to be included in the final common European framework for Primary Care ASP? *

83.

Are there any questions missing that should be considered or any additional information you would like to share? *

84.

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End of the survey You have reached the end of the survey. Thank you for your valuable input and participation. We look forward to working together to develop a comprehensive AMS framework for Primary Care across Europe. Your responses will help us prepare for the WS and ensure meaningful discussions.

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