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Mixed-Method Evaluation of a Community Pharmacy Antimicrobial Stewardship Intervention (PAMSI)

Hayes, Catherine V.; Lecky, Donna M.; Pursey, Fionna; Thomas, Amy; Ashiru-Oredope, Diane; Saei, Ayoub; Thornley, Tracey; Howard, Philip; Dickinson, Aimi; Ingram, Clare; Allison, Rosalie; McNulty, Cliodna A. M.

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Authors

Catherine V. Hayes

Donna M. Lecky

Fionna Pursey

Amy Thomas

Diane Ashiru-Oredope

Ayoub Saei

Philip Howard

Aimi Dickinson

Clare Ingram

Rosalie Allison

Cliodna A. M. McNulty



Abstract

The community pharmacy antimicrobial stewardship intervention (PAMSI) is multi-faceted and underpinned by behavioural science, consisting of the TARGET Antibiotic Checklist, staff e-Learning, and patient-facing materials. This mixed-method study evaluated the effect of PAMSI on community pharmacy staffs' self-reported antimicrobial stewardship (AMS) behaviours. Data collection included staff pre- and post-intervention questionnaires, qualitative interviews, and TARGET Antibiotic Checklists. Quantitative data were analysed by a multivariate ordinal linear mixed effect model; qualitative data were analysed thematically. A total of 101 staff participated from 66 pharmacies, and six completed semi-structured interviews. The statistical model indicated very strong evidence ( < 0.001) that post-intervention, staff increased their antibiotic appropriateness checks and patient advice, covering antibiotic adherence, antibiotic resistance, infection self-care, and safety-netting. Staff reported feeling empowered to query antibiotic appropriateness with prescribing clinicians. The TARGET Antibiotic Checklist was completed with 2043 patients. Topics patients identified as requiring advice from the pharmacy team included symptom duration, alcohol and food consumption guidance, antibiotic side-effects, and returning unused antibiotics to pharmacies. Pharmacy staff acknowledged the need for improved communication across the primary care pathway to optimise antimicrobial use, and PAMSI has potential to support this ambition if implemented nationally. To support patients not attending a pharmacy in person, an online information tool will be developed.

Citation

Hayes, C. V., Lecky, D. M., Pursey, F., Thomas, A., Ashiru-Oredope, D., Saei, A., …McNulty, C. A. M. (2022). Mixed-Method Evaluation of a Community Pharmacy Antimicrobial Stewardship Intervention (PAMSI). Healthcare, 10(7), Article 1288. https://doi.org/10.3390/healthcare10071288

Journal Article Type Article
Acceptance Date Jul 6, 2022
Online Publication Date Jul 12, 2022
Publication Date Jul 12, 2022
Deposit Date Jan 13, 2023
Publicly Available Date Jan 13, 2023
Journal Healthcare
Electronic ISSN 2227-9032
Publisher MDPI AG
Peer Reviewed Peer Reviewed
Volume 10
Issue 7
Article Number 1288
DOI https://doi.org/10.3390/healthcare10071288
Keywords e-learning, qualitative, antimicrobial use, mixed-method, behavioural science, infection self-care, questionnaire, antimicrobial resistance
Public URL https://nottingham-repository.worktribe.com/output/10072998
Publisher URL https://www.mdpi.com/2227-9032/10/7/1288

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