Implementing outpatient antimicrobial stewardship in a primary care office through ambulatory care pharmacist-led audit and feedback.
J Am Pharm Assoc (2003)
; 60(6): e246-e251, 2020.
Article
em En
| MEDLINE
| ID: mdl-32861616
ABSTRACT
OBJECTIVES:
This study aimed to determine the impact of a pharmacist-led antimicrobial stewardship program (ASP) intervention on outpatient antibiotic prescribing for upper respiratory tract infections (URIs) and urinary tract infections (UTIs) in a primary care office. The primary outcome of this study was to characterize antibiotic prescribing over time. Secondary outcomes included describing ambulatory care pharmacist (ACP) workload and types of feedback given.METHODS:
A retrospective pilot study was conducted within a primary care office. The office included a 0.6 full-time equivalent ACP and is part of a health system supported by a pharmacist and a physician co-led ASP. Education and guidelines were provided by the ACP and ASP leads before the intervention period August 2017-February 2018. The ACP provided bi-weekly audit of all URI and UTI prescriptions and written feedback to prescribers.RESULTS:
During the 7-month intervention period, 1107 prescriptions were audited by the ACP, 825 URI and 282 UTI. The most common reasons for feedback included inappropriate agent (26.3%) or prolonged duration of therapy (24.3%). Guideline-concordant agent prescribed for a UTI increased from 20% at baseline to a median of 69.2%, whereas duration increased from 55% to 70.4%. Guideline-concordant agent prescribed for a URI increased from 43.3% to 86.8%, whereas the median duration of therapy decreased from 10 to 7 days.CONCLUSION:
An ACP-led ASP intervention within a primary care office incorporating audit and feedback improved antibiotic prescribing for URIs and UTIs, including prescribing antibiotics when indicated, guideline-concordant antibiotic selection, and duration of therapy. Pharmacists practicing in ambulatory care settings may serve a vital role in leading successful outpatient ASP interventions.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Farmacêuticos
/
Gestão de Antimicrobianos
Tipo de estudo:
Guideline
/
Observational_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article