SPARC, Prescribing Companion Intervention Recording Form

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SPARC, Prescribing Companion Intervention Recording Form

The Prescribing Companion App is designed to provide healthcare providers (both human and animal health), with a core repository of prescribing resources to enable better Antimicrobial Stewardship through a OneHealth approach. To assess the impact of the Prescribing Companion on antimicrobial use, the CPA has designed an intervention form in order to understand the range of interventions made by healthcare professionals as a result of using the Prescribing Companion App.

Country/Region *

Institutional/Organisation Name

If Hospital based, what level of care do you represent?
*

Primary Health Care/ Community

Secondary Health Care

Tertiary Health Care

Quaternary Health Care

Other:

Health professional category
*

Microbiologist/Laboratory technician

Pharmacist

Administration/Finance

Project Manager

Nurse

Medical Doctor

Veterinarian

Policy Maker

Medicines regulator

Health IT/data manager

Village/Community Health Team

Other:

Required

What is your primary area of expertise?
*

Infectious disease management

AMR and/or AMU surveillance

Regulations of medicines

Procurement and Supply of medicines

Policy Maker

Infection Prevention and Control IPC and/or Epidemiology

Environment and/or Animal health

Health care worker

Other:

What sector do you represent in relation to your work?
*

National/sub-national government

Non-governmental organisation/civil Society

Intergovernmental Organisation

Private Sector

Academia

Donor/developmental agency

Other:

What led you to the App today?
*

To check antimicrobial choice for an infection

To check dose

To check course of treatment

To better understand a disease

To check WHO AWaRe list

To find out more about antimicrobial stewardship

Professional development

To understand available animal and/or human health guidance in my country

To understand available animal health guidance in another country

Other:

Required

Did you make any intervention?
*

Yes

What intervention did you make?
*

Dose change

Choice of drug

Formulation change

Dose frequency change

Review date added

Stop date added

Advice given to prescriber on choice/dose of antimicrobial

Advice given to prescriber on length of course

Advice given on antimicrobial stewardship policy

Other:

Required

Please provide more information on intervention made

What other information / resources would you like to find on the App?

Submit

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