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马来西亚雪兰莪州公立医院药剂师对抗菌药物管理计划的认知与实践。

Perception and practices of public hospital pharmacists towards the antimicrobial stewardship programme in the State of Selangor, Malaysia.

机构信息

Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Selangor Branch, Puncak Alam Campus, Puncak Alam, Malaysia.

Department of Physiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

出版信息

Eur J Hosp Pharm. 2020 May;27(3):173-177. doi: 10.1136/ejhpharm-2018-001679. Epub 2018 Nov 26.

Abstract

OBJECTIVE

The increase in antimicrobial resistance and the lack of new antimicrobial agents in drug discovery pipelines have called for global attention to mitigate the problem of antimicrobial misuse. While an antimicrobial stewardship (AMS) programme has been implemented in Malaysia, the perception and practices of public hospital pharmacists remain unknown. The aim of this study was to determine the perception and practices of Malaysian public hospital pharmacists towards the AMS programme in the state of Selangor, Malaysia.

METHODS

A cross-sectional study, using a validated 23-item self-administered questionnaire, was conducted among pharmacists from 11 public hospitals in the State of Selangor, Malaysia, from December 2016 to January 2017. All public hospital pharmacists (n=432) were invited to participate in the survey. A 5-point Likert scale was employed in the questionnaire; the perception section was scored from 1 (strongly disagree) to 5 (strongly agree) while the practice section was scored from 1 (never) to 5 (always). Both descriptive and inferential statistical analyses were used to analyse data.

RESULTS

Of the 432 pharmacists surveyed, 199 responded, giving a response rate of 46.0%. The majority of the respondents agreed (n=190, 95.5%) that the AMS programme improves patient care at their hospitals (median=5; IQR=1). Slightly less than half of the respondents indicated that a local antibiotic guideline was established in their hospitals (median=3, IQR=2.5), and had taken part in antimicrobial awareness campaigns to promote optimal use of antimicrobials in hospitals (median=3, IQR=1).

CONCLUSIONS

Overall, the perception and practices of the surveyed hospital pharmacists towards AMS programme were positive. National antibiotic guidelines, which take into consideration local antimicrobial resistance patterns, should be used fully to improve antimicrobial usage and to reduce practice variation. Collaboration among healthcare professionals should be strengthened to minimise the unfavourable consequences of unintended use of antimicrobial agents while optimising clinical outcomes.

摘要

目的

抗菌药物耐药性的增加和药物发现管道中新抗菌药物的缺乏引起了全球对抗菌药物滥用问题的关注。虽然马来西亚已经实施了抗菌药物管理(AMS)计划,但公众对公立医院药剂师的看法和实践仍不清楚。本研究旨在确定马来西亚雪兰莪州公立医院药剂师对抗菌药物管理计划的看法和实践。

方法

本研究采用横断面研究设计,于 2016 年 12 月至 2017 年 1 月期间,使用经过验证的 23 项自我管理式问卷对马来西亚雪兰莪州 11 家公立医院的药剂师进行调查。邀请所有公立医院药剂师(n=432)参加调查。问卷采用 5 级 Likert 量表;感知部分的评分范围为 1(非常不同意)至 5(非常同意),而实践部分的评分范围为 1(从不)至 5(总是)。采用描述性和推断性统计分析方法分析数据。

结果

在接受调查的 432 名药剂师中,有 199 名(46.0%)做出了回应。大多数受访者(n=190,95.5%)认为 AMS 计划可改善其所在医院的患者护理(中位数=5;IQR=1)。略低于一半的受访者表示,他们所在医院制定了当地抗生素指南(中位数=3,IQR=2.5),并参与了抗菌药物意识宣传活动,以促进医院内抗生素的合理使用(中位数=3,IQR=1)。

结论

总体而言,调查中医院药剂师对抗菌药物管理计划的看法和实践是积极的。应充分使用考虑当地抗菌药物耐药模式的国家抗生素指南,以改善抗菌药物的使用并减少实践差异。应加强医护专业人员之间的协作,以尽量减少抗菌药物意外使用的不利后果,同时优化临床效果。

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