Jacinda Abdul-Mutakabbir, PharmD, MPH, AAHIVP, discusses her work on the Equity in Antimicrobial Stewardship Efforts (EASE) framework, including progress for it, and how other institutions or providers can implement it.
Jacinda Abdul-Mutakabbir, PharmD, MPH, AAHIVP, assistant professor of Clinical Pharmacy, University of California San Diego, was working with her research partner, Karen Tan, PhamD, BCIDP, assistant professor, Pharmacy Practice School of Pharmacy, Loma Linda University, and they discovered disparities in how antimicrobials were being prescribed across different racial and ethnic groups. Their study of disparities and social determinants expanded and developed into a framework around these findings.
“For us, it really became clear that there were not only racial and ethnic disparities, but disparities in terms of social vulnerability, disparities in terms of sexuality, and gender. And it really pushed us to think about how can we address these things?” recalled Abdul-Mutakabbir. “And we really developed our own set of steps for walking through how it is that we wanted to engage in the research. And we developed the [Equity in Antimicrobial Stewardship Efforts] (EASE) framework."
The framework is aimed at shining a light on inequities as it equates to antimicrobial prescribing practices and strategies to reduce them. She was part of a team that published a paper earlier this year that detailed the framework comprehensively in Antimicrobial Stewardship & Healthcare Epidemiology.
Jasmine Marcelin, MD, FACP, FIDSA, associate professor, Department of Internal Medicine, associate medical director, Antimicrobial Stewardship Program, joined the project early on and stressed the importance of collecting data as a starting point.
To learn more about EASE, watch our 2-part interview with Abdul-Mutakabbir and Marcelin from earlier this year.
Part 1: A Novel Framework to Address Antimicrobial Stewardship Disparities
Part 2: Implementing Strategies and Measuring Interventions to Reduce Antimicrobial Stewardship Disparities
“She always says you have to start with the data. You have to start with the numbers, because that is how we really investigate where the inequities exist,” Abdul-Mutakabbir said. "So I think for us, we had to start with our own data. Then we started to think, well, how do we grab the institution specific data? Then we thought we have to disaggregate the data based on areas of vulnerability. So, we started with race and ethnicity, and then we progressed to social vulnerability.”
For other institutions that are considering implementing the EASE framework, Abdul-Mutakabbir says to start small with a singular project.
“When you take on multiple areas, it can be hard to think about how to address each of these things adequately,” she said. So, if in your hospital, you've noted potential disparities in racial and ethnic minoritized status start there. If you think about another area of a social determinant of health, maybe education, maybe language, start there. If you think about Medicaid use and sharing status, start there. So think about your population and what you see, then how it is that you should address those things moving forward.”
