Objective:The World Health Organization (WHO) included single-pill combination (SPC) antihypertensive medications on their 2019 essential medicines list (EML) to encourage uptake and improved hypertension control. We documented key nationallevel facilitators (SPCs on national EMLs, recommendation for SPCs in national hypertension guidelines and availability of SPCs on the market) supporting uptake of SPCs in the 30 most populous low-and middle-income countries (LMICs).Methods: A hierarchical information gathering strategy was used including literature and web searches, the use of organisational databases and personal communications with colleagues to obtain information on (1) whether SPC antihypertensives are on national EMLs, (2) whether SPC antihypertensives are recommended in national hypertension guidelines and (3) whether SPCs are available on the market.Results: Eleven of 30 LMICs had all facilitators in place being Egypt,
Background
Education of undergraduate healthcare professionals (HCPs) on antimicrobial stewardship (AMS) and antimicrobial resistance (AMR) is recommended as an important strategy to prepare future HCPs for their roles in these areas.1 There is limited qualitative research investigating the views of clinical and academic staff involved in the teaching of undergraduate HCP students on current AMS/AMR education practices and curricula.
Objectives
To explore the views and experiences of clinical and academic staff involved in HCP and public health programmes on AMS and AMR education.
Methods
A qualitative study using semi-structured interviews was conducted in October to December 2020. The interview participants were purposively sampled to recruit clinical or academic staff involved in education of students on undergraduate HCP programmes (dentistry, medicine, nursing and midwifery, pharmacy) and public health programmes in an Irish university. Participants were asked to outline their views on current teaching and assessment methods, use of AMS competency frameworks and potential areas for improvement. Interview recordings were conducted online, the recordings were transcribed verbatim, and transcripts analysed by thematic analysis. Ethical approval was obtained, and all participants provided written informed consent.
Results
Interviews were conducted with 15 participants (10 female). A range of disciplines were represented as outlined in the methods. The main interview themes included the challenge of balancing curriculum priorities and capacity in HCP programmes, the importance of ensuring student understanding of AMS/AMR principles, and patient centred application of knowledge. Current teaching and assessment methods were found to vary between the HCP programmes with a mix of didactic lectures and workshops, and assessment ranging from written exams and multiple choice questions to observed structured clinical exams. Very few participants reported educating different HCP students together. Participants were asked to review an antimicrobial education competency framework,2 with most participants believing that this would improve the structure of AMS education, ensuring that key learning outcomes would be addressed in the curriculum. The importance of preparing students for interprofessional practice in AMS in the future was identified as a key theme, with participants highlighting the importance of interprofessional education opportunities to foster communication and teamwork skills in AMS at an early stage.
Conclusions
The importance of AMS and AMR education in HCP programmes was reported in this study, however the main challenge is limited curricular space in busy HCP programmes. Education may be improved by aligning AMS education with an appropriate competency framework. Enhancement of undergraduate interprofessional education opportunities, to prepare students for interprofessional AMS in future practice, is recommended.
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