familiarity and use of rapid diagnostics 865
table 2. Factors Associated with Respondent’s Familiarity (Defined as Very Familiar) With Different Rapid Diagnostic Tests PCR
Multiplex PCR Variable
Hospital type Community hospital Teaching hospital Other
Institution size 0–200 beds
201–500 beds >500 beds
Time in practice 0–5 y
6–10 y >10 y
Formal ID training No Yes
26–75% >75%
Certificate program only
Time dedicated to stewardship <25%
NA PCR PNA FISH
MALDI-TOF OR 95% CI OR 95% CI OR 95% CI OR 95% CI OR 95% CI Ref Ref Ref Ref Ref Ref Ref Ref Ref Ref Ref Ref Ref Ref Ref Ref Ref Ref Ref Ref Ref
0.90 (0.43–1.87) 1.59 (0.68–3.73) 0.91 (0.37–2.27) 0.81 (0.31–2.11) 2.01 (0.91–4.46) 1.92 (0.79–4.67) 1.88 (0.72–4.96) 3.50 (1.17–10.43) 5.54 (1.96–15.71) 1.34 (0.50–3.56)
Ref
1.62 (0.75–3.48) 1.37 (0.56–3.38) 3.99 (1.35–11.79) 1.86 (0.66–5.30) 1.80 (0.72–4.53) 1.00 (0.40–2.48) 0.77 (0.27–2.25) 4.37 (1.30–14.71) 1.77 (0.54–5.82) 1.91 (0.68–5.39)
Ref
1.06 (0.50–2.26) 0.44 (0.18–1.09) 0.32 (0.12–0.91) 1.41 (0.54–3.68) 0.37 (0.15–0.90) 1.33 (0.64–2.75) 1.44 (0.63–3.27) 1.93 (0.78–4.76) 2.39 (0.92–6.24) 1.28 (0.59–2.81)
Ref
3.00 (1.44–6.26) 4.30 (1.69–10.98) 22.53 (4.59–110.65) 7.00 (2.18–22.51) 2.38 (1.03–5.49) 1.61 (0.74–3.49) 1.67 (0.59–4.73) 23.93 (4.64–123.47) 2.51 (0.71–8.83) 1.45 (0.57–3.73)
Ref
1.46 (0.72–2.97) 1.55 (0.65–3.71) 1.96 (0.76–5.05) 3.05 (1.06–8.81) 1.85 (0.81–4.21) 1.79 (0.82–3.91) 2.64 (1.06–6.56) 1.87 (0.70–5.02) 2.99 (0.97–9.22) 2.20 (0.92–5.29)
NOTE. PCR, polymerase chain reaction; OR, odds ratio; CI, confidence interval; NA, nucleic acid; PNA FISH, peptide nucleic acid fluorescent in situ hybridization, MALDI-TOF, matrix-assisted laser desorption/ionization time-of-flight; ID, infectious diseases.
pharmacist groups with specific ID interest, which may confer selection bias and may overestimate positive results. Further- more, only 166 of 224 respondents completed the section assessing outcomes to RDTs, which could have influenced results. The survey was not controlled for duplicate institu- tions. Questions were geared toward identifying pharmacists’ current knowledge of RDTs and were not designed to assess whether this knowledge was obtained at a previous institution. Lastly, causality cannot be fully determined. The results of this survey demonstrate the opportunity for
pharmacists to improve their knowledge surrounding utiliza- tion and implementation of RDTs, with additional opportu- nity to educate other professions, including nursing and medical staff. Efforts are needed to improve communication of alerts to fully realize the benefit of timely results. Continued research in various practice settings is needed to evaluate the impact of RDT on patient and ASP-associated outcomes.
in real time. Quality outcomes and cost-effectiveness research surrounding implementation of RDTs in combination with ASPs is critical, especially given the significant initial financial investment required as well as the heterogeneity of health sys- tems employing them. Future research should identify barriers to routinely measuring clinical outcomes for RDTs as ASP metrics.9 Organizations such as the Society for Healthcare Epi- demiology of America support programmatic training on anti- microbial stewardship research, including assessment of both process and outcomes measures.10 Several limitations exist in our study. The survey was sent to
acknowledgments
Weacknowledge the Society of Infectious Diseases Pharmacists (SIDP) and the American College of Clinical Pharmacy Infectious Diseases Practice and Research Network (ACCP ID PRN) for allowing distribution of our survey.We acknowledge Brandon Hill, PharmD, for his assistance in manuscript editing. Financial support. None reported. Potential conflicts of interest. P.B.B. reports service as a content developer for
and has received honorarium from Rockpointe and
FreeCe.com, and he has received grant support from the Centers for Disease Control and Prevention. C.M.B. reports having received grant support from ALK Abello and an honorarium from Merck. All other authors report no conflicts of interest.
Affiliations: 1. Department of Clinical Pharmacy and Outcomes Sciences, Uni-
versity of South Carolina College of Pharmacy, Columbia, South Carolina; 2. Vizi- ent, Houston, Texas; 3. Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Savannah, Georgia; 4. Department of Pharmacy, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Address correspondence to Monica V. Mahoney, PharmD, BCPS AQ-ID,
Beth Israel Deaconess Medical Center, 1 Deaconess Road, CCB-027, Boston, MA 02215 (
mgolik@bidmc.harvard.edu). PREVIOUS PRESENTATION. These data were presented at ID Week 2016, New Orleans, Louisiana on October 29, 2016 (Abstract #1883)
Received December 20, 2016; accepted March 15, 2017; electronically published May 11, 2017 © 2017 by The Society for Healthcare Epidemiology of America. All rights reserved. 0899-823X/2017/3807-0015. DOI: 10.1017/ice.2017.67
supplementary material
To view supplementary material for this article, please visit https:/
doi.org/10.1017/ice.2017.67
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