Exploring the discord between pharmacy education and practice in antimicrobial stewardship

Abstract

Background: Antimicrobial stewardship (AMS) is a critical global intervention aimed at optimising antimicrobial use and decreasing antimicrobial resistance (AMR) with pharmacists playing a pivotal role within AMS teams. However, AMS is not comprehensively taught in pharmacy curricula and little is known about the relevance of pharmacists’ training to meet AMS needs in South Africa.Aim: This study aimed to explore the attitudes, knowledge and perceptions of clinical pharmacists towards AMS participation and training in South Africa.Setting: This study was conducted among clinically practicing pharmacists in public and private healthcare sectors in South Africa.Methods: A quantitative exploratory research design was selected for this study. The study was conducted using a self-administered structured survey. Categorical variables were analysed using simple descriptive statistics. Mann–Whitney and Kruskal–Wallis tests were applied to determine differences between variables.Results: Pharmacists demonstrated good attitudes knowledge and perceptions towards AMS (median 4.3). There was statistical significant differences in AMS participation between pharmacists of different years of experience (p = 0.005), sector of employment (p = 0.01), position of employment (p = 0.015) and presence of AMS programmes (p = 0.004). Pharmacists indicated that their Bachelor of Pharmacy undergraduate studies inadequately prepared them for their role in AMS (median 4.3).Conclusion: Pharmacists show positive attitudes, knowledge and perceptions towards AMS. Education and training in AMS principles is obtained through master’s programmes, short courses, Continued Professional Development (CPDs) and workshops and insufficiently incorporated in undergraduate programmes.Contribution: This study confirms that undergraduate pharmacy programmes inadequately prepare pharmacists for their role in AMS.

Public hospital pharmacists’ knowledge, attitudes, and practices for antibiotic stewardship implementation in Limpopo Province, South Africa

“…In this study, pharmacists showed poor and inconsistent practice as an equal number of respondents (< 40.0%) have never attended an ASP committee meeting, have sometimes attended infection prevention and control committee meetings, and have almost always attended pharmacy and therapeutic committee meetings, indicating inconsistent attendance among clinical governance structures. Similar to prior research conducted in South Africa, pharmacists in Limpopo Hospitals expressed a desire for training in ASP [ 14 , 16 – 18 ]. The inadequate coverage of the ASP subject in South Africa’s undergraduate pharmacy education curricula may account for the high demand for ASP training among study respondents [ 14 , 18 ].…”

“…Globally, there is inadequate pre-service and in-service education to prepare healthcare professionals for ASP, broad perceptions and attitudes, as well as practice diversity on ASP, leading to inappropriate antibiotic prescribing and use [ 13 , 14 ]. Comprehensive knowledge and understanding of ASPs are important in implementing ASP interventions [ 13 ].…”

“…Comprehensive knowledge and understanding of ASPs are important in implementing ASP interventions [ 13 ]. Clinical pharmacists in the public and private sectors of South Africa believe that ASP knowledge is least likely to be acquired during undergraduate pharmacy training because undergraduate programs inadequately prepare pharmacists for their ASP role [ 14 ]. Knowledge, attitude, and practices (KAP) studies establish baseline knowledge, myths, misconceptions, attitudes, beliefs, and behaviors related to a specific topic and provide contextualized intervention [ 15 ].…”

“…Few studies on KAP for ASP implementation have previously been conducted in South Africa [ 14 , 16 – 18 ]. These studies have included other health professionals (e.g., medical doctors and nurses), all sectors of pharmacy practice and pharmacy students [ 14 , 16 – 18 ], but none have exclusively focused on hospital pharmacists in the public sector.…”

“…Few studies on KAP for ASP implementation have previously been conducted in South Africa [ 14 , 16 – 18 ]. These studies have included other health professionals (e.g., medical doctors and nurses), all sectors of pharmacy practice and pharmacy students [ 14 , 16 – 18 ], but none have exclusively focused on hospital pharmacists in the public sector. Hospital pharmacists’ perspectives on ASP participation are important, considering the inadequate implementation of the South African national antimicrobial stewardship framework in public sector hospitals [ 16 ].…”