Designing a National Veterinary Prescribing Champion Programme for Welsh Veterinary Practices: The Arwain Vet Cymru Project.

Gwen M Rees,Alison Bard,Kristen K Reyher

doi:10.3390/antibiotics10030253

Abstract

Antimicrobial use in agriculture has been identified as an area of focus for reducing overall antimicrobial use and improving stewardship. In this paper, we outline the design of a complex antimicrobial stewardship (AMS) intervention aimed at developing a national Veterinary Prescribing Champion programme for Welsh farm animal veterinary practices. We describe the process by which participants were encouraged to design and deliver bespoke individualised AMS activities at practice level by forging participant “champion” identities and communities of practice through participatory and educational online activities. We describe the key phases identified as important when designing this complex intervention, namely (i) involving key collaborators in government and industry to stimulate project engagement; (ii) grounding the design in the literature, the results of stakeholder engagement, expert panel input, and veterinary clinician feedback to promote contextual relevance and appropriateness; and (iii) taking a theoretical approach to implementing intervention design to foster critical psychological needs for participant motivation and scheme involvement. With recruitment of over 80% of all farm animal practices in Wales to the programme, we also describe demographic data of the participating Welsh Veterinary Prescribing Champions in order to inform recruitment and design of future AMS programmes.

Highlights

Antimicrobial resistance (AMR) is a global One Health challenge of great significance [1]
As the Veterinary Prescribing Champion Network is a novel intervention—with similar programmes being considered for England and Scotland—this paper aims to inform future national stewardship programmes about its design, methodology, and enactment, providing a much-needed evidence base for future complex interventions in the veterinary sphere
A total of 43 farm animal veterinary surgeons were recruited to the Arwain Vet Cymru (AVC) project from March 2020, representing 41 veterinary practices across Wales

Summary

Introduction

Antimicrobial resistance (AMR) is a global One Health challenge of great significance [1]. While the development and transmission of AMR is complex and not yet fully understood, antimicrobial use is known to be a major driver of resistance and there is broad consensus that antimicrobial stewardship (AMS) is a key component in addressing the issue [2,3,4]. In the UK context, recent efforts have led to a decrease in overall antimicrobial use in food-producing animals of 45% since 2015 [9]. These reductions have been broadly industry-led, with industry bodies recognising a consumer demand for responsible antimicrobial use and an increasing political focus on the issue [10,11,12].

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Conclusion