J Am Pharm Assoc (2003). 2022 Jul-Aug;62(4):1239-1248.e1. doi: 10.1016/j.japh.2022.02.003. Epub 2022 Feb 11.
Community health care accounts for the vast majority of antibiotic use in Europe. Given the threat of antimicrobial resistance (AMR), there is an urgent need to develop new antimicrobial stewardship (AMS) interventions in primary care that could involve different health care providers, including community pharmacists.
This study aimed to explore the perceptions, currents practices, and interventions of community pharmacists regarding AMS.
Semistructured qualitative interviews were conducted with community pharmacists in France. Participants were recruited through a professional organization of community pharmacists combined with a snowballing technique. Interviews were audio recorded, transcribed, and analyzed using thematic analysis. The Consolidated Framework for Implementation Research was used while developing the interview guide and carrying out thematic analysis.
Sixteen community pharmacists participated. All the respondents had good awareness about antimicrobial resistance and believed that community pharmacists had an important role in tackling AMR. Some barriers to community pharmacists' participation in AMS were identified such as difficult interactions with prescribers, lack of time, and lack of access to patient medical records and diagnosis. Increased patient education, audits and feedback of antibiotic prescribing, increased point-of-care testing, and delayed prescribing were interventions suggested by the pharmacists to improve antibiotic use in primary care. Strategies cited by participants to facilitate the implementation of such interventions are increased pharmacist-general practitioner collaboration, specialized training, clinical decision support tools, and financial incentives.
This study suggests that community pharmacists could play a greater role in infection management and AMS interventions. Further interprofessional collaboration is needed to optimize antibiotic prescribing and utilization in community health care.
在欧洲，社区卫生保健占据了抗生素使用的绝大部分。鉴于抗菌药物耐药性（AMR）的威胁，迫切需要在初级保健中开发新的抗菌药物管理（AMS）干预措施，其中可能涉及不同的卫生保健提供者，包括社区药剂师。
本研究旨在探讨社区药剂师对抗菌药物管理的看法、当前做法和干预措施。
对法国的社区药剂师进行了半结构式定性访谈。参与者是通过社区药剂师的专业组织与滚雪球技术相结合招募的。对访谈进行了录音、转录和主题分析。在制定访谈指南和进行主题分析时使用了实施研究综合框架。
共有 16 名社区药剂师参与。所有受访者对抗菌药物耐药性都有很好的认识，并认为社区药剂师在对抗 AMR 方面发挥着重要作用。确定了一些社区药剂师参与抗菌药物管理的障碍，例如与处方医生的互动困难、时间不足以及无法获取患者的病历和诊断。提高患者教育、抗生素处方审核和反馈、增加即时检测、延迟处方等干预措施被药剂师建议用于改善初级保健中的抗生素使用。参与者提到的促进这些干预措施实施的策略包括增加药剂师与全科医生的合作、专门培训、临床决策支持工具和经济激励。
本研究表明，社区药剂师可以在感染管理和抗菌药物管理干预措施中发挥更大的作用。需要进一步的跨专业合作，以优化社区卫生保健中的抗生素处方和使用。
