Survey Of Pharmacist Involvement And Needs For Antimicrobial Stewardship Globally

• By: LEGENZA, Laurel (University of Wisconsin-Madison, United States)
• Co-author(s): Dr Laurel Legenza (University of Wisconsin-Madison, Madison, United States)
  Dr Sura AlMahasis (University of Wisconsin-Madison, Madison, United States)
  Dr José Pablo Díaz Madriz (Pharmacy Department, Hospital Clínica Bíblica, San José, Costa Rica)
  
• Abstract:

  Background: Antimicrobial resistance is a global health threat that requires coordinated antimicrobial stewardship (AMS) initiatives and interventions. AMS programmes are often led or co-led by pharmacists. Yet, there is a gap in understanding the current extent of pharmacist and pharmaceutical scientist involvement in AMS globally and across health systems, including in hospital and community pharmacy settings.
  
  Purpose: The survey was developed to understand the current state of pharmacist involvement and needs for antimicrobial stewardship (AMS) globally. Results will help identify what resources are available for AMS across regions and determine what type of training is needed related to AMS and where regionally.
  
  Methods: An online global AMS survey questionnaire was developed at the University of Wisconsin-Madison School of Pharmacy with the UW-Madison Survey Center and input from the International Pharmaceutical Federation (FIP) Board of Pharmaceutical Practice (BPP), the FIP Hospital Pharmacy Section (HPS), the HPS World Hospital Pharmacy Research Consortium, the FIP Community Pharmacy Section, and the FIP Antimicrobial Resistance Commission. The survey was launched at the FIP 2023 World Congress in Brisbane, Australia. The survey recruitment information was later shared in partnership with the FIP Global Observatory via email and social media distributions. FIP Sections and individual members of the HPS Research Committee also contributed to the distribution. The study is supported by the FIP BPP.
  
  Results:
  As of the survey recruitment mid-point (late February 2024), 174 surveys were completed, representing 42 countries. The highest proportions of respondents were from Pakistan (17.8%), Costa Rica (11.5%), and New Zealand (5.8%). Within the completed surveys, 58 respondents reported practicing in a community pharmacy (33%). When asked to indicate a primary practice setting, 73 respondents completed this question and the majority worked in academic medical centers/teaching hospitals (32%, n=23) or referral/tertiary hospitals (22%, n=16), followed by community pharmacies (19%, n=14) and community hospitals (11%, n=8). Ten respondents reported practicing in an ambulatory clinic (7%) or at a primary care clinic (7%). The majority of hospital pharmacists answering if they performed AMS activities at their hospital indicated that ‘Yes’ they perform AMS activities (Yes n=48, 89%; No n=6, 11%). When asked about the training received to improve awareness and understanding of antimicrobial resistance, 44.3% (n=77) of all respondents indicated they had received “some but not enough” training. Some pharmacists indicated they had received “just the right amount” of training (23.0%, n=40), while 13.2% (n=23) stated they had received no training.
  
  Conclusion:
  Results indicate a high global representation in the survey results thus far and the results can inform regional specific AMS initiatives for both hospital and community pharmacy settings. Pharmacists’ engagement in performing AMS activities varied. There is a clear need for pharmacy specific AMS training informed by local needs. This will empower pharmacists and pharmaceutical scientists to effectively support AMS activities, improve awareness and understanding of antimicrobial resistance, and ensure the appropriate use of antibiotics.