Allison Rosalie, Chapman Sarah, Howard Philip, Thornley Tracey, Ashiru-Oredope Diane, Walker Sue, Jones Leah F, McNulty Cliodna A M
The Letter g, Harpenden, UK.
University of Leeds, Leeds, UK.
JAC Antimicrob Resist. 2020 Oct 29;2(4):dlaa089. doi: 10.1093/jacamr/dlaa089. eCollection 2020 Dec.
Community pharmacy staff have an opportunity to play a pivotal role in antimicrobial stewardship (AMS) due to their expertise in medicines and accessibility to patients.
To develop and test the feasibility of a pharmacy AMS intervention (PAMSI) to increase community pharmacy staff's capability, opportunity and motivation to check antibiotic appropriateness and provide self-care and adherence advice when dispensing antibiotics.
The PAMSI was centred around an Antibiotic Checklist, completed by patients and pharmacy staff, to facilitate personalized advice to the patient, based on their reported knowledge. An educational webinar for staff and patient-facing materials were also developed. Staff and patients completing Antibiotic Checklists were invited to provide feedback via questionnaires.
In February 2019, 12 community pharmacies in England trialled the intervention. Forty-three pharmacy staff evaluated the educational webinar and reported increases in their understanding, confidence, commitment and intention to use the tools provided to give adherence and self-care advice. Over 4 weeks, 931 Antibiotic Checklists were completed. Staff reported being more focused on giving advice and able to address patients' knowledge gaps (mainly: likely symptom duration; alcohol and food consumption advice; possible side effects from antibiotics; returning unused antibiotics to the pharmacy), resulting in increased self-reported effective and meaningful conversations.
Implementation of a PAMSI is feasible and effectively promotes AMS. Pharmacy staff and commissioners should consider this within their AMS plans. An optional digital format of the Antibiotic Checklist should be explored, for patients who are not collecting their antibiotic prescriptions themselves, and to save printing costs.
社区药房工作人员凭借其在药品方面的专业知识以及与患者的接触机会，有机会在抗菌药物管理（AMS）中发挥关键作用。
开发并测试一种药房抗菌药物管理干预措施（PAMSI）的可行性，以提高社区药房工作人员在调配抗生素时检查抗生素使用合理性以及提供自我护理和依从性建议的能力、机会和积极性。
PAMSI以一份抗生素清单为核心，由患者和药房工作人员填写，以便根据患者报告的知识为其提供个性化建议。还为工作人员开展了一次教育网络研讨会，并制作了面向患者的材料。邀请填写抗生素清单的工作人员和患者通过问卷提供反馈。
2019年2月，英格兰的12家社区药房对该干预措施进行了试验。43名药房工作人员对教育网络研讨会进行了评估，并报告称他们在理解、信心、实施意愿以及使用所提供工具给予依从性和自我护理建议方面有所提高。在4周时间里，共完成了931份抗生素清单。工作人员报告称，他们在提供建议时更加专注，能够弥补患者的知识空白（主要包括：可能的症状持续时间；饮酒和饮食建议；抗生素可能的副作用；将未使用的抗生素退回药房），从而使自我报告的有效且有意义的对话有所增加。
实施PAMSI是可行的，并且能有效促进抗菌药物管理。药房工作人员和决策者应在其抗菌药物管理计划中考虑这一点。对于那些不亲自领取抗生素处方的患者，应探索抗生素清单的可选数字格式，以节省印刷成本。
