Attitudes toward using clinical decision support in community pharmacies to promote antibiotic stewardship.
Journal
Journal of the American Pharmacists Association : JAPhA
ISSN: 1544-3450
Titre abrégé: J Am Pharm Assoc (2003)
Pays: United States
ID NLM: 101176252
Informations de publication
Date de publication:
Historique:
received:
13
12
2020
revised:
04
04
2021
accepted:
08
04
2021
pubmed:
9
5
2021
medline:
28
10
2021
entrez:
8
5
2021
Statut:
ppublish
Résumé
Outpatient antibiotic prescriptions drive antibiotic overuse in humans, and the Centers for Disease Control and Prevention has identified community pharmacies as potential partners in outpatient stewardship efforts. Clinical decision support (CDS) tools can potentially be used at community pharmacies to aid in outpatient stewardship efforts. We sought to determine community pharmacist attitudes toward using a computerized CDS tool to evaluate and manage common complaints and thus promote appropriate antibiotic prescribing. We conducted in-depth semistructured interviews of community pharmacists to determine attitudes toward using CDS tools in their practice and identify potential barriers in implementation. Thematic analysis was used to identify common themes and subthemes in the pharmacist responses. We interviewed 21 pharmacists and identified 5 themes and 14 subthemes in our interviews. The pharmacists reported that patients frequently presented with complaints of acute infections and that they (the pharmacists) were universally supportive of a CDS intervention that would allow them to assess such patients and, in turn, guide appropriate antibiotic prescribing. They noted that communication difficulties with prescribing physicians and lack of information sharing currently made it difficult to implement stewardship interventions, and they stated that they were interested in any intervention that could help overcome these barriers. Community pharmacies represent an important point of contact for patients and are a potentially valuable setting for outpatient stewardship interventions. Pharmacists were overwhelmingly supportive of using CDS tools to evaluate patients and promote antimicrobial stewardship. These results suggest that it would be feasible to pilot such an intervention in the community pharmacy setting.
Sections du résumé
BACKGROUND
Outpatient antibiotic prescriptions drive antibiotic overuse in humans, and the Centers for Disease Control and Prevention has identified community pharmacies as potential partners in outpatient stewardship efforts. Clinical decision support (CDS) tools can potentially be used at community pharmacies to aid in outpatient stewardship efforts.
OBJECTIVES
We sought to determine community pharmacist attitudes toward using a computerized CDS tool to evaluate and manage common complaints and thus promote appropriate antibiotic prescribing.
METHODS
We conducted in-depth semistructured interviews of community pharmacists to determine attitudes toward using CDS tools in their practice and identify potential barriers in implementation. Thematic analysis was used to identify common themes and subthemes in the pharmacist responses.
RESULTS
We interviewed 21 pharmacists and identified 5 themes and 14 subthemes in our interviews. The pharmacists reported that patients frequently presented with complaints of acute infections and that they (the pharmacists) were universally supportive of a CDS intervention that would allow them to assess such patients and, in turn, guide appropriate antibiotic prescribing. They noted that communication difficulties with prescribing physicians and lack of information sharing currently made it difficult to implement stewardship interventions, and they stated that they were interested in any intervention that could help overcome these barriers.
CONCLUSION
Community pharmacies represent an important point of contact for patients and are a potentially valuable setting for outpatient stewardship interventions. Pharmacists were overwhelmingly supportive of using CDS tools to evaluate patients and promote antimicrobial stewardship. These results suggest that it would be feasible to pilot such an intervention in the community pharmacy setting.
Identifiants
pubmed: 33962894
pii: S1544-3191(21)00163-1
doi: 10.1016/j.japh.2021.04.008
pmc: PMC8841115
mid: NIHMS1765304
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
565-571Subventions
Organisme : NIDCR NIH HHS
ID : K23 DE029514
Pays : United States
Organisme : NIDCR NIH HHS
ID : L30 DE031146
Pays : United States
Organisme : NIAID NIH HHS
ID : T32 AI007172
Pays : United States
Informations de copyright
Copyright © 2021 American Pharmacists Association®. All rights reserved.
Références
JAMA Netw Open. 2018 Jun 1;1(2):e180243
pubmed: 30646067
J Am Pharm Assoc (2003). 2021 Jan-Feb;61(1):13-19
pubmed: 33129679
WMJ. 2007 Sep;106(6):326-9
pubmed: 17970014
J Antimicrob Chemother. 2012 Dec;67(12):2949-56
pubmed: 22949624
Open Forum Infect Dis. 2018 Aug 10;5(9):ofy198
pubmed: 30191156
J Fam Plann Reprod Health Care. 2013 Apr;39(2):97-101
pubmed: 22923279
JAMA. 2016 May 3;315(17):1864-73
pubmed: 27139059
J Am Pharm Assoc (2003). 2016 Jan;56(1):14-21
pubmed: 26802915
Res Social Adm Pharm. 2018 Apr;14(4):356-359
pubmed: 28479019
Can Pharm J (Ott). 2018 Jun 03;151(5):305-314
pubmed: 31080530
J Am Pharm Assoc (2003). 2009 Mar-Apr;49(2):164-70
pubmed: 19289342
Am J Manag Care. 2011 Sep;17(9):601-8
pubmed: 21902445
Expert Rev Anti Infect Ther. 2021 Apr;19(4):529-536
pubmed: 32945697
Lancet Glob Health. 2021 May;9(5):e561-e562
pubmed: 33713631
MMWR Recomm Rep. 2016 Nov 11;65(6):1-12
pubmed: 27832047
Ther Adv Drug Saf. 2014 Dec;5(6):229-41
pubmed: 25436105
J Clin Pharm Ther. 2018 Feb;43(1):59-64
pubmed: 28833324
Open Forum Infect Dis. 2017 Oct 26;4(4):ofx171
pubmed: 29732377
J Am Pharm Assoc (2003). 2020 Jan - Feb;60(1):138-144
pubmed: 31405804
PLoS One. 2017 Aug 16;12(8):e0183172
pubmed: 28813473
Can Pharm J (Ott). 2019 Aug 09;152(5):281-282
pubmed: 31534580
Integr Pharm Res Pract. 2015 Jul 01;4:67-77
pubmed: 29354521
Res Social Adm Pharm. 2019 Jun;15(6):627-631
pubmed: 30279131
BMJ Open. 2018 Dec 28;8(12):e025101
pubmed: 30593557
J Fam Pract. 2001 Jul;50(7):589-94
pubmed: 11485707