Formalization of an antimicrobial stewardship program in a small community hospital

Lockwood, Alexa R.; Bolton, N.; Winton, Mark; Carter, Jean T.

doi:10.2146/ajhp160609

Cited by 5 publications

(9 citation statements)

References 11 publications

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“…The views of participants towards the implementation of ASP in public sector hospitals of Pakistan showed readiness to accept the change. Furthermore, the implementation of hospital ASPs in Pakistan will be challenging, but it is a need of the hour, as many countries have successfully implemented ASP in their different hospital settings due to its merits in regard to patient care [18,23,26].…”

Section: Discussionmentioning

confidence: 99%

“…ASP is a coordinated effort that promotes the judicious use of antimicrobials whilst limiting the impact of AMR [20]. The major stakeholders of ASPs include infectious disease (ID) physicians [21], clinical pharmacists [22,23], infection control practitioners [24], and nurses [25] who are playing their defined and expanded roles in preventing and treating infectious diseases. Numerous countries have implemented ASPs in different healthcare settings to get optimal health benefits in terms of reduction in AMR as well as cost-effectiveness in drug therapy [26,27,28,29,30].…”

Section: Introductionmentioning

confidence: 99%

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Perspective of Pakistani Physicians towards Hospital Antimicrobial Stewardship Programs: A Multisite Exploratory Qualitative Study

Hayat

Rosenthal

Gillani

et al. 2019

IJERPH

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Background: Antimicrobial resistance (AMR) is a global threat and the antimicrobial stewardship program (ASP) is a globally used tool to combat AMR. There is little information on the views among Pakistani physicians regarding AMR and the benefits of hospital antimicrobial stewardship implementation. This study was designed to explore the physicians’ views about ASP. Methods: Qualitative face-to-face and telephonic interviews were conducted by using purposive sampling method with 22 physicians working in seven tertiary care public hospitals of Punjab, Pakistan. All interviews were audio recorded and transcribed verbatim. Qualitative software was used, and a thematic analysis was conducted. Results: Three broad themes were identified: (1) the growing concern of antimicrobial resistance in Pakistan, (2) the role(s) of healthcare professionals in antibiotic prescribing, and (3) managing antibiotic resistance in hospitals. Inadequate resources, poor healthcare facilities, and insufficiently trained medical staff were the major hurdles in ASP implementation in Pakistan. Conclusions: Our study found a poor familiarity of hospital ASP among physicians working in public sector tertiary care teaching hospitals, and a number of distinct themes emerged during this study that could be helpful in establishing the concept of hospital ASP in Pakistan. Overall, physicians showed a positive attitude towards the enforcement of ASP in all healthcare settings, including teaching hospitals.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Perspective of Pakistani Physicians towards Hospital Antimicrobial Stewardship Programs: A Multisite Exploratory Qualitative Study

Hayat

Rosenthal

Gillani

et al. 2019

IJERPH

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“…In contrast, we found 15 studies for this time period that were explicitly stated as being MTM services . We also observed seven economic evaluations of CPS focused on antibiotic use, five of which were explicitly stated as antimicrobial stewardship programs . In comparison with the reviews encompassing 2001 through 2010, there were a total of 14 targeted drug programs focusing on antimicrobials, but none were described as being antimicrobial stewardship programs.…”

Section: Discussionmentioning

confidence: 94%

“…Twenty studies evaluated targeted drug programs (Table S3). The majority of these evaluations utilized study designs at high risk of bias. Nonrandomized posttest designs with a historical control comprised 55% studies, followed by single‐group posttest (15%), single‐group pretest‐posttest (10%), and nonrandomized pretest‐posttest with a historical control (5%).…”

Section: Resultsmentioning

confidence: 99%

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Economic evaluations of clinical pharmacy services in the United States: 2011‐2017

Talon

Pérez

Yan

et al. 2019

J Am Coll Clin Pharm

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Studies evaluating the cost-effectiveness of clinical pharmacy services (CPS) are needed to justify implementation and reimbursement. Through a systematic review, we describe services provided by pharmacists and their economic outcomes. We conducted a literature search of published studies in PubMed, Ovid, and Embase from January 2011 through December 2017. Manuscripts evaluating a CPS with patient-level economic outcomes and conducted in the United States were included. Study risks of bias were classified by study design characteristics. Economic evaluations were classified according to the presence of a comparator, and cost and outcome measures included. The quality of full economic evaluations was assessed using the Quality of Health Economic Studies (QHES) instrument. Descriptive statistics were used to summarize CPS characteristics. After screening, 115 studies wereincluded. Type of service provided included general pharmacotherapy (41%), disease management (30%), and targeted drug program (17%). Settings included hospital (34%), ambulatory care (28%), and community pharmacy (17%). Study designs were considered high risk of bias (use of a historical control group or no control group) in 69% of cases while 25% were medium risk of bias (non-randomized with a concurrent control group) and 6% were low risk of bias (randomized experimental or multigroup interrupted time series). Economic evaluation types were descriptive studies that measured cost and/or outcomes of a CPS (55%), comparative studies that measured cost or outcomes of a CPS and a comparator (37%), and full evaluations that measured cost and outcomes of a CPS and a comparator (8%). Among nine full evaluations, the median (range) QHES score was 74 (59-95) and four reported the CPS as being more effective at a lower cost. Few full economic evaluations were conducted, but supported the cost-effectiveness of CPS. Use of a comparator group and measurement of economic inputs and outcomes would strengthen the body of evidence. K E Y W O R D Scost-benefit analysis, health services research, pharmacoeconomics, pharmacy

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Mapping hospital antimicrobial stewardship programmes in the Gulf Cooperation Council states against international standards: a systematic review

Hashad

Perumal²,

Stewart

et al. 2020

Journal of Hospital Infection

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Formalization of an antimicrobial stewardship program in a small community hospital

Cited by 5 publications

References 11 publications

Perspective of Pakistani Physicians towards Hospital Antimicrobial Stewardship Programs: A Multisite Exploratory Qualitative Study

Perspective of Pakistani Physicians towards Hospital Antimicrobial Stewardship Programs: A Multisite Exploratory Qualitative Study

Economic evaluations of clinical pharmacy services in the United States: 2011‐2017

Mapping hospital antimicrobial stewardship programmes in the Gulf Cooperation Council states against international standards: a systematic review

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