ASAP+: involving patients in antimicrobial stewardship

Background:
Antimicrobial resistance (AMR) poses a significant public health challenge, driven largely by inappropriate antibiotic use. In Switzerland, the ASAP (Antibiotic Stewardship in Ambulatory Care Platform) promotes responsible antibiotic prescribing through evidence-based interventions. While clinician-led efforts have made progress, patient involvement remains limited, despite “patient demand” being often cited as key factor in antibiotic overuse. This project seeks to fill the gap in Switzerland by integrating patient perspectives into AMS strategies, particularly in ambulatory care settings where most antibiotics are prescribed, in the context of acute infections—conditions that affect nearly everyone but lack organized patient representation due to their short duration.

Aims

The project has four main objectives:

1. Establish a structured support group of patient-experts to collaborate with researchers and public health actors on AMS.
2. Strengthen health literacy and self-management skills among patients regarding acute infections and antibiotic use.
3. Co-produce patient-centered communication tools that promote appropriate antibiotic use.
4. Assess the impact of patient involvement on the ASAP program’s strategy, organization, and communication materials.

Summarized Methods

The project uses a participatory action research (PAR) approach and unfolds in three phases:

• Phase 1: Establishment and Training
  Three patient-experts will be recruited from diverse linguistic regions and trained in health literacy, antimicrobial stewardship (AMS), and co-production principles. 
• Phase 2: Co-Production and Strategic Participation
  Patient-experts will participate in ASAP’s Scientific and Advisory Committee and annual symposium. They will co-lead strategy discussions and co-produce communication tools using design thinking workshops. These tools will be tailored to patients’ needs and promote self-management
• Phase 3: Impact Assessment
  The project will evaluate changes in ASAP’s strategy and materials through document analysis and interviews. Outcomes will include qualitative insights into the value of patient involvement and comparative analysis of pre/post intervention materials.

Involvement of Patients

Patients are central to this project. The project establishes a structured, trained group of patient-experts who co-lead stewardship activities. They contribute to strategic decisions, co-design communication tools, and advise on research and public campaigns. Their participation ensures that stewardship efforts reflect real patient needs and promote equity, empowerment, and mutual learning. Their roles include:

• Co-leading discussions in ASAP-SAC
• Presenting at the ASAP symposium
• Advising on future research and communication strategies
• Collaborating with partners like PharmaSuisse and FOPH

This structured involvement ensures that patient voices shape AMS interventions from design to implementation.

Expected Impact for “Smarter Medicine – Choosing Wisely Switzerland”

The project aligns directly with Smarter Medicine’s goals, by reducing low-value care such as inappropriate antibiotic prescribing and by promoting innovative, patient-driven approaches to antibiotic stewardship. Given the high incidence of acute infections, it will give high visibility of Smarter Medicine to a wide audience of healthcare professionals and patients.

Benefits for Patients and/or the Public

Patients will benefit from clear, culturally appropriate information on antibiotic use and acute infections, fostering informed decision-making and self-management. This can reduce unnecessary prescriptions and improve health outcomes. The inclusive, multilingual approach ensures relevance across Switzerland’s diverse population.