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The misuse of antibiotics is a factor contributing to the rise of resistance particularly in countries where there is a lack of procedures for restricting and auditing antibiotic prescriptions. There is very limited data from Kuwait exploring the community pharmacists' role towards reducing antibiotic misuse and resistance and so the aim of this study is to assess community pharmacists' knowledge and practice towards antibiotic resistance in Kuwait. A cross sectional study was conducted among the primary care centers' pharmacists in Al-Asema and Hawally districts in Kuwait between June-July 2018, using a self-administered online questionnaire. Out of 274, 156 pharmacists completed the questionnaire. A total of 148 pharmacists (95%) strongly agreed/agreed that antibiotics can cause allergic reaction. Moreover, results showed that a significant proportion of the participants (n= 42, 27.6%) never take part in antimicrobial awareness campaigns to promote the optimal use of antibiotics. Pharmacists in primary care settings in Kuwait have excellent knowledge and good practice toward antibiotics resistance. These findings will aid in encouraging collaborative work between pharmacists and other health care professional to limit antibiotic resistance in Kuwait and provide further insight in designing future interventions to reduce antibiotic resistance in Kuwait.

Introduction Asthma is a respiratory disease caused by chronic airway inflammation in the lungs that constricts the airway and increases mucus production.1 Asthma is considered the most common chronic disease of people living in Kuwait.2 Pharmacists can play key roles to support optimal health outcomes for patients with asthma. However, there is limited evidence describing pharmacists’ experiences of asthma treatment in primary care centres in Kuwait. Aim To explore pharmacists’ perspectives about asthma treatment in primary care centers in Kuwait. Methods Pharmacists were recruited via convenience sampling and passive snowballing techniques. Qualitative, online semi-structured, interviews were conducted via Zoom. The topic guide consisted of several sections that included demographic characteristics, pharmacists’ role in asthma management, their experiences with asthma patients, significant barriers for pharmacists to provide optimal asthma services, their relationship and collaboration with other healthcare professionals, and finally suggestions for an ideal asthma management service. Recorded interviews were transcribed verbatim and analysed utilizing NVivo® 11 software. Data were inductively analysed to identify themes using the Braun and Clarke framework. Ethical approval was obtained from the Ministry of health in Kuwait. Results Fifteen interviews with pharmacists were conducted. The sample consisted of more females (n=13) than males (n=2). Most pharmacists had work experience of five-ten years as pharmacists in primary care centres (n=9). Also, most of them worked in primary care centres located in Al-Asema (the capital) district (n=7). Emergent themes from the interviews were: pharmacist’s role in asthma care, factors hindering them from providing optimal asthma care and facilitators to deliver optimal asthma care. Pharmacists described their roles as dispensing medications prescribed by doctors and demonstrating inhalation techniques for first-time users of inhalers. Pharmacists reported limited authority to alter asthma treatment. However, they showed interests to expand their role in asthma care. Most pharmacists reported that physicians had the most significant role in asthma management and patients trusted physicians more than pharmacists to manage their asthma. Many factors influenced pharmacists’ involvement in asthma services, including time, consultation room space, low levels of knowledge and patients’ and physicians’ attitudes towards pharmacists. Additionally, poor access to patients’ medical and health information and the absence of job descriptions for pharmacists in Kuwait were considered barriers to delivering asthma care services. Interprofessional collaboration, task delegation, role clarification and additional training were reported as needed to deliver asthma care services in primary care centers. Discussion/Conclusion There is potential for pharmacists to contribute to asthma care services in Kuwait. However poor access to information about patients and the absence of job descriptions for pharmacists in Kuwait may limit pharmacists’ involvement in asthma services. A limitation of this study is that pharmacists were mostly from the capital so findings may not be applicable to the whole of Kuwait. References 1. WHO. Asthma. 2022 [Online]. Available: https://www.who.int/news-room/fact-sheets/detail/asthma [Accessed 8 March 2021]. 2. Abul, A. T., Nair, P. C., Behbehanei, N. A. Sharma, P. N. Hospital admissions and death rates from asthma in Kuwait during pre- and post-Gulf War periods. Ann Allergy Asthma Immunol, 2001;86:465-8.