Saha Sajal K, Kong David C M, Thursky Karin, Mazza Danielle
Department of General Practice, Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill, VIC 3168, Australia.
National Centre for Antimicrobial Stewardship (NCAS), The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia.
Antibiotics (Basel). 2021 Jan 5;10(1):47. doi: 10.3390/antibiotics10010047.
Setting up an interprofessional team for antimicrobial stewardship (AMS) to improve the quality and safety of antimicrobial use in primary care is essential but challenging. This study aimed to investigate the convergent and divergent attitudes and views of general practitioners (GPs) and community pharmacists (CPs) about AMS implementation and their perceived challenges of collaboration to design a GP-pharmacist collaborative AMS (GPPAS) model. Nationwide surveys of GPs and CPs across Australia were conducted January-October 2019. Chi square statistics and a theoretical framework were used for comparative analyses of quantitative and qualitative data, respectively. In total, 999 participants responded to the surveys with 15.4% ( = 386) response rates for GPs and 30.7% ( = 613) for CPs. GPs and CPs were aware about AMS however their interprofessional perceptions varied to the benefits of AMS programs. CPs indicated that they would need AMS training; significantly higher than GPs (GP vs. CP; 46.4% vs. 76.5%; < 0.0001). GPs' use of the Therapeutic Guideline Antibiotic was much higher than CPs (83.2% vs. 45.5%; < 0.0001). No interprofessional difference was found in the very-limited use of patient information leaflets ( < 0.1162) and point-of-care tests ( < 0.7848). While CPs were more willing ( < 0.0001) to collaborate with GPs, both groups were convergent in views that policies that support GP-CP collaboration are needed to implement GPPAS strategies. GP-pharmacist collaborative group meetings (54.9% vs. 82.5%) and antimicrobial audit (46.1% vs. 86.5%) models were inter-professionally supported to optimise antimicrobial therapy, but an attitudinal divergence was significant ( < 0.001). The challenges towards GP-CP collaboration in AMS were identified by both at personal, logistical and organisational environment level. There are opportunities for GP-CP collaboration to improve AMS in Australian primary care. However, strengthening GP-pharmacy collaborative system structure and practice agreements is a priority to improve interprofessional trust, competencies, and communications for AMS and to establish a GPPAS model in future.
组建一个跨专业的抗菌药物管理（AMS）团队以提高初级医疗中抗菌药物使用的质量和安全性至关重要，但也具有挑战性。本研究旨在调查全科医生（GPs）和社区药剂师（CPs）对AMS实施的趋同和不同态度及观点，以及他们在合作设计全科医生 - 药剂师协作AMS（GPPAS）模型时所感知到的挑战。2019年1月至10月在澳大利亚全国范围内对全科医生和社区药剂师进行了调查。卡方统计和一个理论框架分别用于定量和定性数据的比较分析。共有999名参与者回复了调查，全科医生的回复率为15.4%（= 386），社区药剂师的回复率为30.7%（= 613）。全科医生和社区药剂师了解AMS，然而他们对AMS项目益处的跨专业认知存在差异。社区药剂师表示他们需要AMS培训；显著高于全科医生（全科医生与社区药剂师；46.4%对76.5%；< 0.0001）。全科医生对《治疗指南 - 抗生素》的使用远高于社区药剂师（83.2%对45.5%；< 0.0001）。在患者信息手册（< 0.1162）和即时检验（< 0.7848）的使用非常有限方面未发现跨专业差异。虽然社区药剂师更愿意（< 0.0001）与全科医生合作，但两组在观点上趋同，即需要支持全科医生 - 社区药剂师合作的政策来实施GPPAS策略。全科医生 - 药剂师协作小组会议（54.9%对82.5%）和抗菌药物审核（46.1%对86.
