Barriers and enablers to blood culture sampling in Indonesia, Thailand and Viet Nam: a Theoretical Domains Framework-based survey
Issued Date
2024-02-19
Resource Type
eISSN
20446055
Scopus ID
2-s2.0-85185710383
Pubmed ID
38373855
Journal Title
BMJ open
Volume
14
Issue
2
Rights Holder(s)
SCOPUS
Bibliographic Citation
BMJ open Vol.14 No.2 (2024) , e075526
Suggested Citation
Suntornsut P., Asadinia K.S., Limato R., Tamara A., Rotty L.W.A., Bramanti R., Nusantara D.U., Nelwan E.J., Khusuwan S., Suphamongkholchaikul W., Chamnan P., Piyaphanee W., Lan Vu H.T., Nguyen Y.H., Nguyen K.H., Pham T.N., Le Q.M., Vu V.H., Chau D.M., Thi Hoang Vo D.E., Harriss E.K., van Doorn H.R., Hamers R.L., Lorencatto F., Atkins L., Limmathurotsakul D. Barriers and enablers to blood culture sampling in Indonesia, Thailand and Viet Nam: a Theoretical Domains Framework-based survey. BMJ open Vol.14 No.2 (2024) , e075526. doi:10.1136/bmjopen-2023-075526 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/97418
Title
Barriers and enablers to blood culture sampling in Indonesia, Thailand and Viet Nam: a Theoretical Domains Framework-based survey
Author(s)
Suntornsut P.
Asadinia K.S.
Limato R.
Tamara A.
Rotty L.W.A.
Bramanti R.
Nusantara D.U.
Nelwan E.J.
Khusuwan S.
Suphamongkholchaikul W.
Chamnan P.
Piyaphanee W.
Lan Vu H.T.
Nguyen Y.H.
Nguyen K.H.
Pham T.N.
Le Q.M.
Vu V.H.
Chau D.M.
Thi Hoang Vo D.E.
Harriss E.K.
van Doorn H.R.
Hamers R.L.
Lorencatto F.
Atkins L.
Limmathurotsakul D.
Asadinia K.S.
Limato R.
Tamara A.
Rotty L.W.A.
Bramanti R.
Nusantara D.U.
Nelwan E.J.
Khusuwan S.
Suphamongkholchaikul W.
Chamnan P.
Piyaphanee W.
Lan Vu H.T.
Nguyen Y.H.
Nguyen K.H.
Pham T.N.
Le Q.M.
Vu V.H.
Chau D.M.
Thi Hoang Vo D.E.
Harriss E.K.
van Doorn H.R.
Hamers R.L.
Lorencatto F.
Atkins L.
Limmathurotsakul D.
Author's Affiliation
Faculty of Tropical Medicine, Mahidol University
Mahidol Oxford Tropical Medicine Research Unit
Oxford University Clinical Research Unit
Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo
Universitas Indonesia
University of Oxford
University College London
Hospital for Tropical Diseases, Bangkok
Nuffield Department of Medicine
Dr. Iskak District Hospital
Dong Thap University
Pasar Minggu Hospital
Sunpasitthiprasong Hospital
Prof. Dr. R. D. Kandou General Hospital
Viet Tiep Hospital
National Hospital of Tropical Diseases
Chiangrai Prachanukroh Hospital
Mahidol Oxford Tropical Medicine Research Unit
Oxford University Clinical Research Unit
Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo
Universitas Indonesia
University of Oxford
University College London
Hospital for Tropical Diseases, Bangkok
Nuffield Department of Medicine
Dr. Iskak District Hospital
Dong Thap University
Pasar Minggu Hospital
Sunpasitthiprasong Hospital
Prof. Dr. R. D. Kandou General Hospital
Viet Tiep Hospital
National Hospital of Tropical Diseases
Chiangrai Prachanukroh Hospital
Corresponding Author(s)
Other Contributor(s)
Abstract
OBJECTIVE: Blood culture (BC) sampling is recommended for all suspected sepsis patients prior to antibiotic administration. We examine barriers and enablers to BC sampling in three Southeast Asian countries. DESIGN: A Theoretical Domains Framework (TDF)-based survey, comprising a case scenario of a patient presenting with community-acquired sepsis and all 14 TDF domains of barriers/enablers to BC sampling. SETTING: Hospitals in Indonesia, Thailand and Viet Nam, December 2021 to 30 April 2022. PARTICIPANTS: 1070 medical doctors and 238 final-year medical students were participated in this study. Half of the respondents were women (n=680, 52%) and most worked in governmental hospitals (n=980, 75.4%). OUTCOME MEASURES: Barriers and enablers to BC sampling. RESULTS: The proportion of respondents who answered that they would definitely take BC in the case scenario was highest at 89.8% (273/304) in Thailand, followed by 50.5% (252/499) in Viet Nam and 31.3% (157/501) in Indonesia (p<0.001). Barriers/enablers in nine TDF domains were considered key in influencing BC sampling, including 'priority of BC (TDF-goals)', 'perception about their role to order or initiate an order for BC (TDF-social professional role and identity)', 'perception that BC is helpful (TDF-beliefs about consequences)', 'intention to follow guidelines (TDF-intention)', 'awareness of guidelines (TDF-knowledge)', 'norms of BC sampling (TDF-social influence)', 'consequences that discourage BC sampling (TDF-reinforcement)', 'perceived cost-effectiveness of BC (TDF-environmental context and resources)' and 'regulation on cost reimbursement (TDF-behavioural regulation)'. There was substantial heterogeneity between the countries. In most domains, the lower (higher) proportion of Thai respondents experienced the barriers (enablers) compared with that of Indonesian and Vietnamese respondents. A range of suggested intervention types and policy options was identified. CONCLUSIONS: Barriers and enablers to BC sampling are varied and heterogenous. Cost-related barriers are more common in more resource-limited countries, while many barriers are not directly related to cost. Context-specific multifaceted interventions at both hospital and policy levels are required to improve diagnostic stewardship practices.