E. TAY1, L. H. WONG1, S. T. HENG1, H. GUO1, ANDREA LH KWA2, T. M. NG1, SHIMIN J CHUNG2, J. SOMANI3, DAVID C LYE1, A. CHOW1
Tan Tock Seng Hospital1, Singapore General Hospital2, National University Hospital3
Antimicrobial resistance(AMR) is a serious public health threat. Antimicrobial stewardship programmes(ASPs) in hospital settings are predominantly led by specific ASP physicians and pharmacists. Limited studies have been conducted to appreciate non-ASP trained hospital pharmacists’ perspectives on their roles in antimicrobial stewardship. A qualitative study was conducted to explore facilitators and barriers faced by hospital pharmacists in antimicrobial stewardship.
Focus group discussions(FGDs) were conducted with 74 hospital pharmacists, purposively sampled from three largest acute-care public hospitals in Singapore. Applied thematic analysis was used to analyze the data and codes were categorized using the Social Ecological Model(SEM).
At the intrapersonal level, pharmacists identified themselves as reviewers for drug safety before dispensing, confining themselves to a restricted advisory role. They felt that their lack of clinical knowledge and experience hindered them from contributing actively to physicians’ decisions on antibiotic prescribing. At the interpersonal level, pharmacists often experienced difficulties conveying their opinions and recommendations on antibiotic choice and dose to physicians despite frequent communication. Nonetheless, pharmacists were actively involved in educating patients and their caregivers on the essential knowledge for antibiotic use. At the organizational level, in-house antibiotic guidelines were found to be useful by hospital pharmacists in supporting their antibiotic interventions and recommendations. Finally, at the community level, pharmacists observed that there was generally low public awareness and knowledge on antibiotic use and AMR.
These findings provide important insights into the gaps to be addressed in order to harness the untapped potential of hospital pharmacists and fully engage them in antimicrobial stewardship.