Trial Outcomes & Findings for Dissemination and Implementation of a Videoconference Antimicrobial Stewardship Team (NCT NCT05319561)
NCT ID: NCT05319561
Last Updated: 2026-05-01
Results Overview
Days of antibiotic therapy per 1000 days of care (DOT/1000 DOC) measures the overall rate of antibiotic use and is a common metric that accounts for dose adjustments, such as for people who receive dialysis. Administration of any dose of an antimicrobial on a given day represents a single DOT for that agent, regardless of the number of times the doses are administered or the dose strength. This metric gauges overall antibiotic use, capturing both the number of prescriptions as well as the length of prescriptions issued. It also helps benchmark use across facilities, tracks prescribing trends, and assesses the impact of stewardship efforts.
COMPLETED
NA
8 participants
The study period was 15 months following each the first meeting held by each VAST. The first 3 months were considered a wash-in period. Data analysis focused on the subsequent 12 month period.
2026-05-01
Participant Flow
VA ID physicians and potential rural VAMCs were recruited through professional networks within VHA to form Videoconference Antimicrobial Stewardship Teams or VASTs. While some VAST teams were created through existing relationships between the ID physician and the rural VAMC, other VASTs were established via outreach to the rural sites' infection preventionists and/or pharmacists involved in antimicrobial stewardship.
Unit of analysis: VA Medical Centers
Participant milestones
| Measure |
VAST+
Sites are rural VA Medical Centers that work with an ID physician at different VA to conduct regular discussions about infectious diseases and antimicrobial use for Veterans receiving care at the rural VAMC. These dyads formed the Videoconference Antimicrobial Stewardship Teams or VASTs. VAST+ sites received a brief (2 page) Antibiotic Use Report that described summarized the antibiotic use at the rural VAMC acute care and CLC over the previous month, including a comparison to the average antibiotic use among other rural VAMCs in the same Medical Complexity Group. The Antibiotic Use Reports were distributed quarterly during the intervention period. (Dose: Antibiotic Use Report; Dose Form: 1-2 pdfs sent via email to Rural VAMC and ID physician forming their VAST; Frequency: Reports were sent quarterly).
|
VAST -
Sites are rural VA Medical Centers that work with an ID physician at different VA to conduct regular discussions about infectious diseases and antimicrobial use for Veterans receiving care at the rural VAMC. These dyads formed the Videoconference Antimicrobial Stewardship Teams or VASTs. VAST- sites received no additional information about antibiotic use at their rural VAMC.
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|---|---|---|
|
Overall Study
STARTED
|
0 4
|
0 4
|
|
Overall Study
COMPLETED
|
0 4
|
0 4
|
|
Overall Study
NOT COMPLETED
|
0 0
|
0 0
|
Reasons for withdrawal
Withdrawal data not reported
Baseline Characteristics
VA Medical Center sites only - participant baseline characteristics data were not collected
Baseline characteristics by cohort
| Measure |
VAST+
n=4 VA Medical Centers
Sites are rural VA Medical Centers that work with an ID physician at different VA to conduct regular discussions about infectious diseases and antimicrobial use for Veterans receiving care at the rural VAMC. These dyads formed the Videoconference Antimicrobial Stewardship Teams or VASTs. VAST+ sites received a brief (2 page) Antibiotic Use Report that described summarized the antibiotic use at the rural VAMC acute care and CLC over the previous month, including a comparison to the average antibiotic use among other rural VAMCs in the same Medical Complexity Group. The Antibiotic Use Reports were distributed quarterly during the intervention period. (Dose: Antibiotic Use Report; Dose Form: 1-2 pdfs sent via email to Rural VAMC and ID physician forming their VAST; Frequency: Reports were sent quarterly).
|
VAST -
n=4 VA Medical Centers
Sites are rural VA Medical Centers that work with an ID physician at different VA to conduct regular discussions about infectious diseases and antimicrobial use for Veterans receiving care at the rural VAMC. These dyads formed the Videoconference Antimicrobial Stewardship Teams or VASTs. VAST- sites received no additional information about antibiotic use at their rural VAMC.
|
Total
n=8 VA Medical Centers
Total of all reporting groups
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|---|---|---|---|
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Ethnicity (NIH/OMB)
Hispanic or Latino
|
0 VA Medical Centers
VA Medical Center sites only - participant baseline characteristics data were not collected
|
0 VA Medical Centers
VA Medical Center sites only - participant baseline characteristics data were not collected
|
0 VA Medical Centers
VA Medical Center sites only - participant baseline characteristics data were not collected
|
|
Age, Customized
VA Medical Centers
|
0 VA Medical Centers
n=4 VA Medical Centers
|
0 VA Medical Centers
n=4 VA Medical Centers
|
0 VA Medical Centers
n=8 VA Medical Centers
|
|
Sex/Gender, Customized
VA Medical Centers
|
0 VA Medical Centers
n=4 VA Medical Centers
|
0 VA Medical Centers
n=4 VA Medical Centers
|
0 VA Medical Centers
n=8 VA Medical Centers
|
|
Ethnicity (NIH/OMB)
Not Hispanic or Latino
|
0 VA Medical Centers
VA Medical Center sites only - participant baseline characteristics data were not collected
|
0 VA Medical Centers
VA Medical Center sites only - participant baseline characteristics data were not collected
|
0 VA Medical Centers
VA Medical Center sites only - participant baseline characteristics data were not collected
|
|
Ethnicity (NIH/OMB)
Unknown or Not Reported
|
0 VA Medical Centers
VA Medical Center sites only - participant baseline characteristics data were not collected
|
0 VA Medical Centers
VA Medical Center sites only - participant baseline characteristics data were not collected
|
0 VA Medical Centers
VA Medical Center sites only - participant baseline characteristics data were not collected
|
|
Overall antibiotic Use
|
617 Days of Antibiotic Therapy/1000 Bed Days
STANDARD_DEVIATION 213 • n=4 VA Medical Centers
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795 Days of Antibiotic Therapy/1000 Bed Days
STANDARD_DEVIATION 365 • n=4 VA Medical Centers
|
668 Days of Antibiotic Therapy/1000 Bed Days
STANDARD_DEVIATION 245 • n=8 VA Medical Centers
|
PRIMARY outcome
Timeframe: The study period was 15 months following each the first meeting held by each VAST. The first 3 months were considered a wash-in period. Data analysis focused on the subsequent 12 month period.Population: VA Medical Center sites only - participants were not enrolled
Days of antibiotic therapy per 1000 days of care (DOT/1000 DOC) measures the overall rate of antibiotic use and is a common metric that accounts for dose adjustments, such as for people who receive dialysis. Administration of any dose of an antimicrobial on a given day represents a single DOT for that agent, regardless of the number of times the doses are administered or the dose strength. This metric gauges overall antibiotic use, capturing both the number of prescriptions as well as the length of prescriptions issued. It also helps benchmark use across facilities, tracks prescribing trends, and assesses the impact of stewardship efforts.
Outcome measures
| Measure |
VAST+
n=4 VA Medical Centers
Sites are rural VA Medical Centers that work with an ID physician at different VA to conduct regular discussions about infectious diseases and antimicrobial use for Veterans receiving care at the rural VAMC. These dyads formed the Videoconference Antimicrobial Stewardship Teams or VASTs. VAST+ sites received a brief (2 page) Antibiotic Use Report that described summarized the antibiotic use at the rural VAMC acute care and CLC over the previous month, including a comparison to the average antibiotic use among other rural VAMCs in the same Medical Complexity Group. The Antibiotic Use Reports were distributed quarterly during the intervention period. (Dose: Antibiotic Use Report; Dose Form: 1-2 pdfs sent via email to Rural VAMC and ID physician forming their VAST; Frequency: Reports were sent quarterly).
|
VAST -
n=4 VA Medical Centers
Sites are rural VA Medical Centers that work with an ID physician at different VA to conduct regular discussions about infectious diseases and antimicrobial use for Veterans receiving care at the rural VAMC. These dyads formed the Videoconference Antimicrobial Stewardship Teams or VASTs. VAST- sites received no additional information about antibiotic use at their rural VAMC.
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|---|---|---|
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Days of Antibiotic Therapy Per 1000 Days of Care
|
710 Days of Antibiotic Therapy/1000 Bed Days
Standard Deviation 158
|
744 Days of Antibiotic Therapy/1000 Bed Days
Standard Deviation 332
|
SECONDARY outcome
Timeframe: The study period was 15 months following each the first meeting held by each VAST. The first 3 months were considered a wash-in period. Data analysis focused on the subsequent 12 month period.Population: VA Medical Center sites only - participants were not enrolled
Antibiotic Spectrum Index (ASI) scores range from 1 (narrowest spectrum) to 13 (broadest spectrum). As an example, the ASI scores for penicillin, doxycycline, ciprofloxacin, and ertapenem are 2, 5, 8 and 9, respectively. Broad-spectrum was defined as an ASI of ≥8. The rate of broad-spectrum antibiotic use is determined as the days of broad-spectrum antibiotic therapy per 1000 bed days of care. When compared to overall antibiotic use, this metric helps assess the proportion of antibiotic use comprised by broad-spectrum agents. Normalizing to 1000 bed days of care helps benchmark use across facilities, tracks prescribing trends, and assesses the impact of stewardship efforts.
Outcome measures
| Measure |
VAST+
n=4 VA Medical Centers
Sites are rural VA Medical Centers that work with an ID physician at different VA to conduct regular discussions about infectious diseases and antimicrobial use for Veterans receiving care at the rural VAMC. These dyads formed the Videoconference Antimicrobial Stewardship Teams or VASTs. VAST+ sites received a brief (2 page) Antibiotic Use Report that described summarized the antibiotic use at the rural VAMC acute care and CLC over the previous month, including a comparison to the average antibiotic use among other rural VAMCs in the same Medical Complexity Group. The Antibiotic Use Reports were distributed quarterly during the intervention period. (Dose: Antibiotic Use Report; Dose Form: 1-2 pdfs sent via email to Rural VAMC and ID physician forming their VAST; Frequency: Reports were sent quarterly).
|
VAST -
n=4 VA Medical Centers
Sites are rural VA Medical Centers that work with an ID physician at different VA to conduct regular discussions about infectious diseases and antimicrobial use for Veterans receiving care at the rural VAMC. These dyads formed the Videoconference Antimicrobial Stewardship Teams or VASTs. VAST- sites received no additional information about antibiotic use at their rural VAMC.
|
|---|---|---|
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Days of Broad-spectrum Antibiotic Therapy Per 1000 Bed Days of Care
|
127 Days of antibiotic therapy per 1000 days
Standard Deviation 35
|
188 Days of antibiotic therapy per 1000 days
Standard Deviation 78
|
SECONDARY outcome
Timeframe: The study period was 15 months following each the first meeting held by each VAST. The first 3 months were considered a wash-in period. Data analysis focused on the subsequent 12 month period.Population: VA Medical Center sites only - participants were not enrolled
An antibiotic start is recorded whenever a patient is newly prescribed an antibiotic. The rate of antibiotic starts is determined as the Number of Antibiotic Starts per 1000 Bed Days of Care. This metric gauges overall antibiotic prescribing frequency, helps benchmark use across facilities, tracks prescribing trends, and assesses the impact of stewardship efforts.
Outcome measures
| Measure |
VAST+
n=4 VA Medical Centers
Sites are rural VA Medical Centers that work with an ID physician at different VA to conduct regular discussions about infectious diseases and antimicrobial use for Veterans receiving care at the rural VAMC. These dyads formed the Videoconference Antimicrobial Stewardship Teams or VASTs. VAST+ sites received a brief (2 page) Antibiotic Use Report that described summarized the antibiotic use at the rural VAMC acute care and CLC over the previous month, including a comparison to the average antibiotic use among other rural VAMCs in the same Medical Complexity Group. The Antibiotic Use Reports were distributed quarterly during the intervention period. (Dose: Antibiotic Use Report; Dose Form: 1-2 pdfs sent via email to Rural VAMC and ID physician forming their VAST; Frequency: Reports were sent quarterly).
|
VAST -
n=4 VA Medical Centers
Sites are rural VA Medical Centers that work with an ID physician at different VA to conduct regular discussions about infectious diseases and antimicrobial use for Veterans receiving care at the rural VAMC. These dyads formed the Videoconference Antimicrobial Stewardship Teams or VASTs. VAST- sites received no additional information about antibiotic use at their rural VAMC.
|
|---|---|---|
|
Antibiotic Starts (New Prescriptions)/1000 Bed Days of Care
|
231 antibiotic starts/1000 BDOC
Standard Deviation 65
|
226 antibiotic starts/1000 BDOC
Standard Deviation 96
|
Adverse Events
VAST+
VAST -
Serious adverse events
Adverse event data not reported
Other adverse events
Adverse event data not reported
Additional Information
Robin L. P. Jump, MD, PhD
VA Pittsburgh Healthcare System
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place