What role do pharmacists play in mediating antibiotic use in hospitals? A qualitative study

Broom, A; Broom, J; Kirby, E; Plage, S; Adams, J

What role do pharmacists play in mediating antibiotic use in hospitals? A qualitative study

Broom, A

Broom, J Kirby, E Plage, S Adams, J

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Publication Type:: Journal Article
Citation:: BMJ open, 2015, 5 (11), pp. e008326 - ?
Issue Date:: 2015-11-03

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Field	Value	Language
dc.contributor.author	Broom, A https://orcid.org/0000-0003-1258-1140	en_US
dc.contributor.author	Broom, J	en_US
dc.contributor.author	Kirby, E	en_US
dc.contributor.author	Plage, S	en_US
dc.contributor.author	Adams, J https://orcid.org/0000-0002-9901-5717	en_US
dc.date.issued	2015-11-03	en_US
dc.identifier.citation	BMJ open, 2015, 5 (11), pp. e008326 - ?	en_US
dc.identifier.uri	http://hdl.handle.net/10453/43609
dc.description.abstract	Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ OBJECTIVE: To understand Australian hospital pharmacists' accounts of antibiotic use, and the potential role of pharmacy in antibiotic optimisation within a tertiary hospital setting.DESIGN, SETTING AND PARTICIPANTS: Qualitative study, utilising semistructured interviews with 19 pharmacists in two hospitals in Queensland, Australia in 2014. Data was analysed using the framework approach and supported by NVivo10 qualitative data analysis software.RESULTS: The results demonstrate that (1) pharmacists' attitudes are ambivalent towards the significance of antibiotic resistance with optimising antibiotic use perceived as low priority; (2) pharmacists' current capacity to influence antibiotic decision-making is limited by the prescribing power of doctors and the perception of antibiotic use as a medical responsibility; and, (3) interprofessional and organisational barriers exist that prevent change in the hospital setting including medical hierarchies, limited contact with senior doctors and resource constraints resulting in insufficient pharmacy staffing to foster collaborative relationships and facilitate the uptake of their advice.DISCUSSION: While pharmacy is playing an increasingly important role in enhanced antibiotic governance and is a vital component of antimicrobial stewardship in Australia, role-based limitations, interprofessional dynamics and organisational/resource constraints in hospitals, if not urgently addressed, will continue to significantly limit the ability of pharmacy to influence antibiotic prescribing.	en_US
dc.relation.ispartof	BMJ open	en_US
dc.relation.isbasedon	10.1136/bmjopen-2015-008326	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Anti-Bacterial Agents	en_US
dc.subject.mesh	Health Knowledge, Attitudes, Practice	en_US
dc.subject.mesh	Cooperative Behavior	en_US
dc.subject.mesh	Professional Role	en_US
dc.subject.mesh	Decision Making	en_US
dc.subject.mesh	Drug Resistance, Bacterial	en_US
dc.subject.mesh	Qualitative Research	en_US
dc.subject.mesh	Professional Competence	en_US
dc.subject.mesh	Pharmacists	en_US
dc.subject.mesh	Physicians	en_US
dc.subject.mesh	Pharmacy Service, Hospital	en_US
dc.subject.mesh	Hospitals	en_US
dc.subject.mesh	Queensland	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Interviews as Topic	en_US
dc.title	What role do pharmacists play in mediating antibiotic use in hospitals? A qualitative study	en_US
dc.type	Journal Article
utslib.citation.volume	11	en_US
utslib.citation.volume	5	en_US
utslib.for	1115 Pharmacology and Pharmaceutical Sciences	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	1199 Other Medical and Health Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	open_access
pubs.issue	11	en_US
pubs.publication-status	Published	en_US
pubs.volume	5	en_US

Abstract:

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ OBJECTIVE: To understand Australian hospital pharmacists' accounts of antibiotic use, and the potential role of pharmacy in antibiotic optimisation within a tertiary hospital setting.DESIGN, SETTING AND PARTICIPANTS: Qualitative study, utilising semistructured interviews with 19 pharmacists in two hospitals in Queensland, Australia in 2014. Data was analysed using the framework approach and supported by NVivo10 qualitative data analysis software.RESULTS: The results demonstrate that (1) pharmacists' attitudes are ambivalent towards the significance of antibiotic resistance with optimising antibiotic use perceived as low priority; (2) pharmacists' current capacity to influence antibiotic decision-making is limited by the prescribing power of doctors and the perception of antibiotic use as a medical responsibility; and, (3) interprofessional and organisational barriers exist that prevent change in the hospital setting including medical hierarchies, limited contact with senior doctors and resource constraints resulting in insufficient pharmacy staffing to foster collaborative relationships and facilitate the uptake of their advice.DISCUSSION: While pharmacy is playing an increasingly important role in enhanced antibiotic governance and is a vital component of antimicrobial stewardship in Australia, role-based limitations, interprofessional dynamics and organisational/resource constraints in hospitals, if not urgently addressed, will continue to significantly limit the ability of pharmacy to influence antibiotic prescribing.

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http://hdl.handle.net/10453/43609