PhD Upgrade | Exploring the effectiveness, acceptability, and equity of access of rapid diagnostic tests for AMR in hospitals in the UK

Summary

Developing and implementing rapid diagnostic tests (RDTs) to detect antimicrobial resistance (AMR) in bacterial pathogens is a priority area for the Department of Health and the National Institute for Health Research. RDTs are faster than laboratory-based culture and antibiotic susceptibility testing, allowing prescribers to switch patients onto appropriate antibiotic therapy more quickly than traditional microbiological methods. However, the evidence base underpinning the impact of hospital-and laboratory-based RDTs on patient outcomes and antibiotic prescribing rates is unclear. Moreover, RDT purchasing decisions in the UK occur at the local level, and there is no central database listing the RDTs to which each hospital and laboratory has access. Pilot work in this area indicates that there is wide variation both in perceived need for RDTs, and in RDT uptake across the UK. It is unclear if such variation is due to differences in clinical need. If not, then heterogeneous RDT uptake may be increasing inequity in the NHS. This is often referred to as a ‘postcode lottery’.

I will evaluate the effectiveness, acceptability, and equity of access of RDTs for AMR in the United Kingdom. First, I will conduct a systematic review examining the effect of RDTs for fast-growing gram-positive and gram-negative bacteria on clinical outcomes, antibiotic prescribing rates, acceptability and feasibility in hospitals. Second, I will conduct semi-structured interviews with professionals at six case study sites to investigate the barriers, facilitators, strategies, and decisions taken when accessing RDTs. Third, I will map RDT usage in the NHS, describing the hospital/laboratory linkages, the diffusion of RDTs across the UK, and the level of access to RDTs. This research will contribute to knowledge gaps by refining understanding of local-level practices and identifying opportunities to improve effective and equitable technology diffusion.

Details

Speaker: Rebecca Glover

Supervisors: Mark Petticrew, Sharon Peacock

Date: 21 March 2018

Time: 12:45

Venue: LG4, Tavistock Place

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