Antimicrobial stewardship education in US colleges and schools of pharmacy

Kufel, Wesley D; Jeffres, Meghan N.; MacDougall, Conan; Cho, Jonathan C.; Marx, Ashley; Williams, Dennis

doi:10.1093/jac/dky166

Cited by 26 publications

(56 citation statements)

References 37 publications

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“…AMS, while an integral component of clinical practice today, is inconsistently taught during pharmacy school, with some schools incorporating AMS into the required didactic curriculum and others incorporating it into the elective experiential education curriculum [ 7 , 8 , 13 , 14 , 15 ]. National guidance for how to incorporate AMS education into schools of pharmacy does not exist [ 4 ], and schools incorporating this education typically have a faculty member who practices in infectious diseases [ 7 ]. This study demonstrates didactic AMS instruction coupled with a required application activity during IPPE rotations can increase perceived understanding and application of AMS techniques by pharmacy students in inpatient, ambulatory, and community practice.…”

Section: Discussionmentioning

confidence: 99%

“…In 2018, a survey was sent to infectious diseases faculty or department chairs at 137 schools of pharmacy to assess incorporation of AMS within the curriculum [ 7 ]. A total of 116 schools participated.…”

Section: Introductionmentioning

confidence: 99%

“…Each IPPE rotation totals a minimum of 80 h and has been intentionally incorporated into the curriculum to occur every Friday for a minimum of 8 h per day for 10 consecutive weeks. Dosing optimization [ 7 ]: Utilizing the pharmacokinetic and pharmacodynamic properties of a drug as well as individual patient characteristics to determine optimal antibiotic dosing. Examples include: renal dose adjustment, dose adjustment for indication, extended infusion beta-lactams, pharmacokinetic dosing of vancomycin/aminoglycosides, etc.…”

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confidence: 99%

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Assessing Pharmacy Students’ and Preceptors’ Understanding of and Exposure to Antimicrobial Stewardship Practices on Introductory Pharmacy Practice Experiences

2020

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Antimicrobial stewardship (AMS) is commonly employed, and may be required, in multiple healthcare settings, with pharmacists playing an integral role in developing and conducting AMS techniques. Despite its prevalence, AMS is minimally taught in pharmacy school curricula. In order to increase student and preceptor understanding and application of AMS techniques, the Medical College of Wisconsin School of Pharmacy required introductory pharmacy practice students to complete three checklists and reflections of AMS techniques observed at three different practice settings: inpatient, ambulatory, and community (retail) pharmacy. Student and preceptor understanding and application of AMS techniques were then assessed via voluntary survey. Survey response rates were 43% for pharmacy students, while preceptor response rates were 27%. Student understanding and application of AMS techniques increased after completion of the AMS checklist, with the largest magnitude of change seen with antibiotic selection recommendations and guideline and policy development. Preceptor understanding was minimally impacted by the activity; however, an increase in understanding was seen for allergy assessments, antibiotic time-outs, and vaccine assessments and recommendations. AMS is an important component of pharmacy practice today. Implementation of a checklist and reflection activity within experiential education increases perceived student understanding and application of relevant AMS techniques.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Assessing Pharmacy Students’ and Preceptors’ Understanding of and Exposure to Antimicrobial Stewardship Practices on Introductory Pharmacy Practice Experiences

2020

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“…A 28 item survey was constructed to assess providers' knowledge and attitudes regarding antibiotic prescribing and AS. Survey content and questions were developed utilizing the expertise of ID pharmacists and previous AS research surveys . Qualtrics (Qualtrics, Inc., Provo, Utah) was utilized to design and collect the survey responses.…”

Section: Methodsmentioning

confidence: 99%

Providers' knowledge and perceptions regarding antibiotic stewardship and antibiotic prescribing in rural primary care clinics

Kufel

Mastro

Mogle

et al. 2020

J Am Coll Clin Pharm

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Background: Variation in providers' education and training may contribute to potential antibiotic overprescribing in outpatient settings. Providers in rural settings may not be exposed to or have similar resources readily available as those in urban settings, or be affiliated with academic medical centers. Thus, we sought to evaluate providers' knowledge and perceptions towards antibiotic stewardship (AS) and antibiotic prescribing in rural primary care clinics. Methods:A cross-sectional, multicenter, electronic survey assessing providers' knowledge and perceptions towards AS and antibiotic prescribing was distributed to family medicine and internal medicine clinic providers in rural New York and Pennsylvania.Results: Seventy responses were included resulting in a survey response rate of 33.5% (70/209) with 42.9%, 30%, and 27.1% of responses from physicians, advanced practice providers, and resident physicians, respectively. The most common barrier to improving antibiotic prescribing was patient demands (54.3%). Providers felt more pressured to prescribe antibiotics based on appointment visits of ≤20 minutes compared with >20 minutes (46.4% vs 7.1%, P = .006), as well as those that encountered ≥50 patients in a week compared with <50 patients (55% vs 16.7%, P = .001). All providers strongly agreed or agreed that antibiotics are overprescribed and inappropriate antibiotic use can lead to resistance. However, only 42.9% of providers selected correctly that 90% to 98% of rhinosinusitis are viral and only 5.7% recommended supportive care without antibiotics. Ten percent of providers never heard of AS, yet most providers (84.3%) were interested in receiving more AS education. Importantly, most providers (57.1%, 40/70) indicated that pharmacists were useful resources to assist in appropriate antibiotic prescribing. Conclusions: Variability exists among providers' knowledge and perceptions towardsAS and antibiotic prescribing in rural primary care clinics, yet most providers are interested in additional AS education. Pharmacists are well-positioned to educate providers and implement initiatives related to AS and appropriate antibiotic prescribing.

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“…Previous editions of the toolkit have been used by researchers and academic institutions in the United States [5][6][7][8][9][10][11][12][13][14] and internationally 15 to guide curricular development and revision. A recent survey of U.S. schools and colleges of pharmacy found a median of 23 credit hours devoted to pharmacotherapy, which the authors determined was adequate to provide coverage of tier 1 and tier 2 topics from the ACCP toolkit.…”

mentioning

confidence: 99%

2019 Update to the American College of Clinical Pharmacy Pharmacotherapy Didactic Curriculum Toolkit

Flannery

Soric

Benavides³

et al. 2019

J Am Coll Clin Pharm

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Introduction The American College of Clinical Pharmacy (ACCP) Pharmacotherapy Didactic Curriculum Toolkit was created by the 2008 ACCP Educational Affairs Committee to provide guidance to schools and colleges of pharmacy for didactic pharmacotherapy curricular development. The toolkit was revised and updated by the 2016 ACCP Educational Affairs Committee. Objectives In accordance with the ACCP Board of Regents decision to update the toolkit every 3 years, the 2019 ACCP Publications Committee was charged with updating the 2016 toolkit to guide adequate disease state inclusion and depth of pharmacotherapy coverage in pharmacy curricula. Methods The committee retained the competency‐based tier definitions and organization of the 2016 toolkit. Multiple literature resources were reviewed to assess medical conditions responsive to drug therapy for inclusion in the 2019 toolkit. The committee also reviewed the tier designation for all toolkit entries for appropriateness, given recent advances in medical care and evolving patient care responsibilities of clinical pharmacists. Updates to the toolkit were made by consensus with electronic voting when required. Results The 2019 toolkit contains 302 topics, including 94 (31%) tier 1, 133 (44%) tier 2, and 75 (25%) tier 3 entries. There are 26 additional topics in the updated toolkit, including 12 new tier 1 topics that are generally treated with nonprescription medications. Eleven new topics were added to tier 2, and 20 topics were added to tier 3 (including 11 topics in the Oncologic Disorders section). The tier classification of some conditions was changed to reflect current pharmacy practice expectations. Conclusion As with the 2016 toolkit, the large number of tier 1 topics will require schools and colleges to employ creative teaching strategies to achieve practice competence in all graduates. The large number of tier 2 topics highlights the importance of postgraduate training and experience for pharmacy graduates desiring to provide direct patient care.

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Antimicrobial stewardship education in US colleges and schools of pharmacy

Cited by 26 publications

References 37 publications

Assessing Pharmacy Students’ and Preceptors’ Understanding of and Exposure to Antimicrobial Stewardship Practices on Introductory Pharmacy Practice Experiences

Assessing Pharmacy Students’ and Preceptors’ Understanding of and Exposure to Antimicrobial Stewardship Practices on Introductory Pharmacy Practice Experiences

Providers' knowledge and perceptions regarding antibiotic stewardship and antibiotic prescribing in rural primary care clinics

2019 Update to the American College of Clinical Pharmacy Pharmacotherapy Didactic Curriculum Toolkit

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