Academic Detailing is a Preferred Knowledge Update Tool Among Norwegian Pharmacists to Improve Antibiotic Counseling: Results From a Quantitative Study Employing the Provider Satisfaction With Academic Detailing (PSAD) and the Detailer Assessment of Visit Effectiveness (DAVE) Tools.

Excessive and incorrect use of antibiotics contributes to the rise of antimicrobial resistance (AMR). Given that pharmacists act as final checkpoint before antibiotics is handled over to patients, they play a crucial role in promoting proper antibiotic use and ensuring treatment adherence. However, there is often a gap between the patients' needs and perceptions, and what the pharmacists provide. Improving pharmacists' training is essential for enhancing patient-centered care. The aim of this research was to evaluate the suitability of academic detailing (AD) for improving Norwegian pharmacists' knowledge and practice on adherence promoting counseling of antibiotic patients. Key insights from prior qualitative research regarding community pharmacists' position in promoting optimized antibiotic use were incorporated in a tailored AD program. The AD's suitability was evaluated using the validated "Provider Satisfaction with Academic Detailing" (PSAD) and "Detailer Assessment of Visit Effectiveness" (DAVE) instruments. Additionally, participants preferred knowledge updates method were assessed. Eighty-one of 86 visits completed PSAD (94% response rate). Satisfaction summary score for PSAD was 40.03 (of maximum 45) and scale summary score for DAVE 12.45 (of maximum 15). One-sample t-test (P < .001) indicated preference for AD over other knowledge update methods. This study confirmed that AD is a successful knowledge updating tool for improving adherence promoting counseling among Norwegian pharmacists. Future research should align practice change intentions with actions post-AD and evaluate patient impact.

Exploring patients' adherence to antibiotics by understanding their health knowledge and relational communication in encounters with pharmacists and physicians.

Background: Antibiotics are drugs essential for the treatment of bacterial infections. Widespread and often improper use of antibiotics are driving the emergence of antimicrobial resistance (AMR) globally. A better understanding of the communicated and understood use of antibiotics as well as improved adherence to treatments are needed to meet this public health threat. Objectives: The aim of the study is to explore how knowledge of antibiotic use is collected and communicated between patients, physicians, and pharmacists, and how patients seek, understand and use available information on antibiotics in adherence to prescribed treatment. Methods: Seven focus group interviews were conducted with community pharmacists (three groups, eleven participants), physicians/general practitioners (two groups, thirteen participants), and patients (two groups, eight participants) in Norway. Four focus group interviews were conducted offline and three online. The interview data were analyzed using systematic text condensation in a four-step, descriptive and explorative thematic analysis. Results: Three main themes were developed about patients' adherence to antibiotics: 1. patients' knowledge about antibiotics and AMR; 2. sources of information about antibiotics/AMR; and 3. relational communication. Patient knowledge about both antibiotics and AMR was somewhat limited, and showed considerable variation. Patients relied on the internet, chat sites, printed information, and face-to-face meetings with health professionals for information. Relational communication between patients, physicians, and pharmacists was found to be important in reducing misunderstandings.Vulnerability, limited time, and lack of communication were barriers to receiving and understanding information during patient-physician encounters. Increased knowledge about antibiotics and AMR may result in better adherence to prescribed medications. Conclusions: Patients seek information about antibiotics and AMR in three arenas; digital platforms, printed material and face to face encounters. However, patients often misunderstand important facts relating to this issue. Relational communication between patients, physicians, and pharmacists was important to ensure adherence to treatment regimens. Pharmacists are encouraged to use open-ended questions and build upon the information obtained from the physician to provide patients with tailored advice and ensure proper adherence. Pharmacists' contribution is crucial in optimizing antibiotic use and combating AMR, as they are the final healthcare point of contact before treatment initiation.

Positioning of community pharmacists in interactions with general practitioners and patients regarding prescribing and using antibiotics.

Interprofessional collaboration between general practitioners (GPs) and community pharmacists (CPs) is important for ensuring antibiotics are used correctly and combating antibiotic resistance. The study's main objective was to investigate how CPs, GPs and patients, respectively, position CPs in their interactions with patients on antibiotic-related matters in Norwegian pharmacies. Seven focus-group interviews were performed. Data were analyzed using systematic text condensation. Positioning theory was used to identify positions assigned to CPs by themselves, by GPs and by patients. CPs position themselves as helpful, accessible drug specialists responsible for advising on antibiotic use, but also consider themselves dependent on GP-supplied information to do so. GPs position CPs as helpful, responsible businesspeople who, however, lack clinical experience and are overzealous gatekeepers. Patients position CPs as helpful people who supply information in "everyday language" and as the GP's extended arm. Patients utter they are best served when GPs and CPs collaborate. This discrepancy is a barrier to optimal service to patients in general, and to proper antibiotic use in particular.