Project Snapshot

Surveillance Pillar

Reducing Inappropriate Improving Antibiotic Stewardship in Primary Care Clinics: A Co-design Approach

Principal Investigator: Myles Leslie, PhD

Co-Investigator(s): Lee A Green, MD

Project Theme: Education and Societal Impact

The Aim

We will work alongside family doctors to help them better understand the in-the-moment, and bigger policy factors that shape their decisions to prescribe antibiotics.  We will then present them with tried and tested options from other primary care settings to help them choose the best way to improve antibiotic stewardship in their own clinic.

Why is This Important?

A number of ideas for improving antibiotic stewardship are out there, but the problem of over-prescribing continues.  By using the ideas of co-design, and by working alongside family doctors to understand their work worlds and decisions, we will be helping them to pick, and commit to, the ideas that are the best for their situation.


Our focus is on co-designing an antibiotic stewardship solution with family doctors so that they see it as valid and will commit to putting it into action.  The chosen solution will help reduce the kind of prescribing that leads to antibiotic resistance.

Research Questions

  1. What are the patterns of antibiotic prescribing in adult family medicine clinics?
  2. What are the factors shaping family doctors’ decisions to prescribe antibiotics in those clinics?
  3. Which evidence-based programs to reduce antibiotic prescribing, adapted in which ways to local context, are preferred by family doctors?
  4. How might the uptake of these programs shape the pursuit of other care quality and policy priorities?


Our Approach

Researchers and quality improvement experts from the University of Calgary (UofC), the University of Alberta (UofA), and the Alberta Health Quality Council of Alberta (HQCA) will be working together with administrative staff and family doctors in a large Primary Care Network (PCN) to conduct this research.

One team will work with the numerical data from the PCN to identify patterns in antibiotic prescribing.  Another two teams will conduct interviews with family doctors from the PCN to identify: 1) the factors that shape their prescribing, and 2) how policies and work culture shape their ability to commit to their preferred antibiotic stewardship program.

Leveraged Sources of Support

  • Infrastructure at the UofC School of Public Policy, as well as in-kind contributions from the UofA, and HQCA will be used to leverage the MIF funds.

Knowledge & Technology: Exchange and Exploitation

  • We will work in conjunction with the doctors and PCN leadership to develop an antibiotic stewardship program that targets and reflects the values of family doctors.

Highly Qualified Personnel

  • 1 Research Assistant
  • 1 Research Scientist