Dataset Information

Roles of Infectious Diseases Consultant Pharmacists and Antimicrobial Stewardship Pharmacists: A Survey of Canadian Tertiary Care Academic Hospitals.

ABSTRACT: Background:Infectious diseases consultant (IDC) pharmacists work within an IDC service to care for inpatients with complex infections. With Accreditation Canada's new Required Organizational Practice promoting the establishment of antimicrobial stewardship (AMS) programs, AMS pharmacists are being employed in acute care hospitals. There is potential for overlap in responsibilities between IDC and AMS pharmacists, but there is no literature outlining the current duties for each group in Canada. Objective:To describe the demographic characteristics and roles of IDC and AMS pharmacists in Canadian tertiary care academic hospitals. Methods:A survey of IDC and AMS pharmacists at Canadian tertiary care academic hospitals was conducted between February and April 2015. The questionnaire included questions about the pharmacist's experience, education, and training; the institution where the pharmacist was practising; the IDC or AMS team characteristics; and the pharmacist's roles in clinical, educational, administrative, and research sectors. Results:The survey response rate was 77% (68/88). The 68 respondents self-identified as IDC pharmacists (14 [21%]), AMS pharmacists (34 [50%]), or dual-role IDC and AMS pharmacists (20 [29%]). Compared with AMS pharmacists, IDC pharmacists reported more of the following unique clinical activities: directly communicating with patients, attending rounds, involving patients in decision-making, and providing patient education. The 3 groups of pharmacists described similar educational responsibilities. The AMS pharmacists performed more of the following administrative and research duties: development of antibiograms and preprinted orders, collection of antimicrobial metrics, and drug-use evaluations for antimicrobials. Dual-role IDC and AMS pharmacists were involved in fewer of the unique activities described by those who practised within a single subspecialty. Conclusions:Self-identified IDC and AMS pharmacists in Canadian tertiary care academic hospitals were performing many similar roles; however, distinct differences within the clinical, administrative, and research domains were identified among IDC pharmacists, AMS pharmacists, and those who identified as dual-role IDC and AMS pharmacists.

SUBMITTER: Beach JE

PROVIDER: S-EPMC5737183 | biostudies-literature | 2017 Nov-Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Roles of Infectious Diseases Consultant Pharmacists and Antimicrobial Stewardship Pharmacists: A Survey of Canadian Tertiary Care Academic Hospitals.

Beach Jessica E JE Ramsey Tasha D TD Gorman Sean K SK Lau Tim T Y TTY

The Canadian journal of hospital pharmacy 20171101 6

<h4>Background</h4>Infectious diseases consultant (IDC) pharmacists work within an IDC service to care for inpatients with complex infections. With Accreditation Canada's new Required Organizational Practice promoting the establishment of antimicrobial stewardship (AMS) programs, AMS pharmacists are being employed in acute care hospitals. There is potential for overlap in responsibilities between IDC and AMS pharmacists, but there is no literature outlining the current duties for each group in C ...[more]

PMID: 29299000

Similar Datasets

Project description:ImportanceThe feasibility of core Infectious Diseases Society of America-recommended antimicrobial stewardship interventions in community hospitals is unknown.ObjectiveTo determine the feasibility and results of implementing 2 core stewardship intervention strategies in community hospitals.Design, setting, and participantsThree-stage, multicenter, prospective nonrandomized clinical trial with crossover design. The setting was 4 community hospitals in North Carolina (median bed size, 305; range, 102-425). Participants were all patients receiving targeted study antibacterial agents or alternative, nonstudy antibacterial agents. The study dates were October 2014 through October 2015. All statistical analyses were completed as of October 2016.InterventionsTwo antimicrobial stewardship strategies targeted vancomycin hydrochloride, piperacillin-tazobactam, and the antipseudomonal carbapenems on formulary at the study hospitals: (1) modified preauthorization (PA), in which the prescriber had to receive pharmacist approval for continued use of the antibiotic after the first dose, and (2) postprescription audit and review (PPR), in which the pharmacist would engage the prescriber about antibiotic appropriateness after 72 hours of therapy. Two hospitals performed modified PA for 6 months, then PPR for 6 months after a 1-month washout. The other 2 hospitals performed the reverse.Main outcomes and measuresThe primary outcome was the feasibility of implementing the interventions, determined by (1) approval by hospital administration and committees at each study hospital; (2) completion of pharmacist training; (3) initiation and implementation as determined by number, type, and outcomes of interventions performed; and (4) time required for interventions. Secondary outcomes included antimicrobial use (days of therapy) compared with matched historical periods and length of hospitalization.ResultsA total of 2692 patients (median age, 65 years; interquartile range, 53-76 years) underwent a study intervention; 1413 (52.5%) were female, 1323 (49.1%) were white, and 1047 (38.9%) were African American. Intervention approvals took a median of 95 days (range, 56-119 days); during these discussions, strict PA was deemed not feasible. Instead, the modified PA intervention was used throughout the study. Pharmacists performed 1456 modified PA interventions (median per hospital, 350 [range, 129-628]) and 1236 PPR interventions (median per hospital, 298 [range, 273-366]). Study antimicrobials were determined to be inappropriate 2 times as often during the PPR period (41.0% [435 of 1060] vs 20.4% [253 of 1243]; P < .001). Pharmacists recommended dose change more often during the modified PA intervention (15.9% [232 of 1456] vs 9.6% [119 of 1236]; P < .001) and de-escalation during PPR (29.1% [360 of 1236] vs 13.0% [190 of 1456]; P < .001). The median time dedicated to the stewardship interventions varied by hospital (range of median hours per week, 5-19). Overall antibiotic use decreased during PPR compared with historical controls (mean [SD] days of therapy per 1000 patient-days, 925.2 [109.8] vs 965.3 [109.4]; mean difference, -40.1; 95% CI, -71.7 to -8.6), but not during modified PA (mean [SD] days of therapy per 1000 patient-days, 931.0 [102.0] vs 926.6 [89.7]; mean difference, 4.4; 95% CI, -55.8 to 64.7).Conclusions and relevanceStrict PA was not feasible in the study hospitals. In contrast, PPR was a feasible and effective strategy for antimicrobial stewardship in settings with limited resources and expertise.Trial registrationClinicalTrials.gov identifier: NCT02212808.

Project description:Background Despite increasing interest in antimicrobial stewardship (AMS), little is known about the related practices and perceptions of community pharmacists. Objective To develop and validate a questionnaire to measure the current practices of, and barriers to community pharmacists' participation in AMS. Setting Community pharmacists in Tasmania, Australia. Method A questionnaire to explore AMS knowledge, current practices and perceptions of community pharmacists was developed. It was designed after rigorous literature review, expert opinion, and feedback from a group of community pharmacists. A convenience sample of 140 Tasmanian community pharmacists was used for this study. Cronbach's alpha and exploratory factor analysis (EFA) were used for reliability and validity. The questionnaire was hosted online, a link to which was sent by invitation e-mails, fax and post to community pharmacists in Tasmania, Australia. Main outcome measure Current AMS practices, perceived importance, barriers and facilitators of AMS. Results Eighty-five pharmacists responded to the survey yielding a response rate of 61%. EFA identified one factor solution for each of three perceptions scales and showed acceptable reliability. The Cronbach's alpha of perceived importance-understanding was 0.699, perceived importance-motivating was 0.734, perceived support from GPs was 0.890, operational barriers was 0.585, general facilitators was 0.615. Most pharmacists reported that they counselled patients on adverse effects (86%), drug interactions (94%), and allergies (96%). In contrast, less than half (43%) intervened with prescribers regarding antibiotic selection. Lack of training, lack of access to patients' records, limited interactions with general practitioners and absence of a reimbursement model were major barriers limiting community pharmacists' participation in AMS. Conclusion The questionnaire was of acceptable reliability and validity; a larger study will further contribute in its reliability and validity. Future studies utilising the questionnaire at national and international level may provide further insights into the determinants of community pharmacist's involvement in AMS.

Dataset Information

Roles of Infectious Diseases Consultant Pharmacists and Antimicrobial Stewardship Pharmacists: A Survey of Canadian Tertiary Care Academic Hospitals.

Publications

Roles of Infectious Diseases Consultant Pharmacists and Antimicrobial Stewardship Pharmacists: A Survey of Canadian Tertiary Care Academic Hospitals.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets