Formative Research with Clinicians for the Development of Quantitative Metrics to Improve Antibiotic Prescribing Behavior in the Outpatient Setting

Attachment A

Form Approved

OMB Control No. 0920-1154

Exp. Date: 1/31/2020

Formative Research with Clinicians for the Development of Quantitative Metrics to Improve Antibiotic Prescribing Behavior in the Outpatient Setting

Thank you all for agreeing to talk with us today. My name is [name], and I’ll be moderating our focus group today. Let me start by telling you a little about our research project, then we’ll go over some ground rules and get started.

We are conducting this focus group on behalf of the Centers for Disease Control and Prevention. Your responses will be shared with the CDC. Our focus group is part of a study being conducted by Dr. Jeffrey S. Gerber, an Infectious Diseases doctor at CHOP that seeks to develop an evidence-based benchmark rate of antibiotic prescribing for children with ARTIs in order to facilitate antibiotic stewardship in pediatric primary care. The goal of our discussion today is to understand what you think about our proposed benchmark rate and to elicit your feedback about how the metric can be best communicated and used to help improve antibiotic prescribing for children with ARTIs. This information will be used to design an education intervention that will be rolled out across the CHOP network.

Here are some ground rules about today’s focus group:

• Participation in this research focus group is voluntary – you can leave at any time and you don’t need to answer any questions you don’t want to answer.

• The session will be audio-taped, although we cannot guarantee complete privacy as participants may discuss the conversation we have outside of this meeting, we will keep your answers private.

• To protect your privacy, what is said on the recording will be professionally transcribed. Any names or identifiers will be removed and then the recordings will be destroyed.

• If possible, please avoid using the names of specific people in the discussion. However, if you do use any specific names they will be removed when the recording is transcribed.

• We will only report the results of the group as a whole, so that no individuals in the group can be identified.

• We will not tell any non-participating staff member that you participated in this project.

• Please remember to respect the privacy of the other members of this group, and don’t discuss what is said in this group after you leave.

• Since what each of you has to say is important to us, we would ask that you speak one at a time.

• Since we are recording the conversation, we would also ask that you try to speak up so we will be able to get what you say when we are transcribing the audio recording.

• I may call on you if you are quiet or ask you to give others a chance to talk if you have a lot to say as we need to get everyone’s thoughts on the questions.

Again, our objective today is to hear your thoughts and opinions about ways to measure antibiotic use in the pediatric primary care setting and how these data can be used to drive improvements in practice.

Your input is crucial – You’re the experts. Please be as honest and open as possible.

Discussion Questions

Warm Up/Opening Questions

1. Let’s start by going around the room, stating your first name, your role in the practice, and how long you’ve been working at this practice and at CHOP in general.

2. What are some reasons why antibiotics might be overused for ARTIs in this practice?

3. Do you currently have access to any data on how you prescribe antibiotics?

   • Where is it from?

   • What do you think about it?

   • If you don’t have access to data, would you like to?

4. Have you heard of the term “antibiotic stewardship”?

   • If yes, what are your thoughts about it?

JEFF GERBER TO PRESENT ON METRIC, BENCHMARK AND RATIONALE FOR THE INTERVENTION

5. What is your initial impression of what we just presented?

6. Does the metric and benchmark make sense to you?

   • If not, how could it be made clearer?

7. How might you like to see these metrics incorporated into your practice?

   • How would you like these metrics communicated to you?

8. Do you think these metrics will impact how you use antibiotics for ARTIs?

9. Do you have suggestions of how we can educate prescribers about these metrics?

   • How we might incorporate them into an intervention?

Public reporting burden of this collection of information is estimated to average 60 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB Control Number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA 0920-1154