Open AccessEvaluation of a consultant audit and feedback programme to improve the quality of antimicrobial prescribing in acute medical admissions
Author(s) -
Roberts Elaine,
Dawoud Dalia M.,
Hughes Dyfrig A.,
Cefai Christopher
Publication year - 2015
Publication title -
international journal of pharmacy practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.42
H-Index - 37
eISSN - 2042-7174
pISSN - 0961-7671
DOI - 10.1111/ijpp.12173
Subject(s) - medicine , antimicrobial stewardship , medical prescription , pharmacist , audit , family medicine , emergency medicine , intervention (counseling) , antimicrobial , pharmacy , nursing , antibiotics , antibiotic resistance , chemistry , management , organic chemistry , microbiology and biotechnology , economics , biology
Abstract Objectives This study aims to evaluate the effectiveness and acceptability of a pharmacist‐led antimicrobial stewardship intervention, consisting of consultant performance audit and feedback, on antimicrobial prescribing quality. Methods From O ctober 2010 to S eptember 2012, the prescribing performance of medical consultant teams rotating on the acute medical admissions unit was measured against four quality indicators. Measurements were taken at baseline then at quarterly intervals during which time consultants received feedback. Proportion of prescriptions adhering to each indicator was compared with baseline using paired sample z ‐test (significance level P < 0.01, Bonferroni corrected). Consultants' views were explored using anonymous questionnaires. Key findings Overall, 2609 antimicrobial prescriptions were reviewed. Improvement from baseline was statistically significant in all follow‐up periods for two indicators: ‘antimicrobials should have a documented indication in the medical notes’ and ‘antimicrobials should adhere to guideline choice or have a justification for deviation’, reaching 6.0% (95% CI 2.5, 9.6) and 8.7% (95% CI 3.7, 13.7), respectively. Adherence to the indicator ‘antimicrobials should have a documented stop/review prompt’ improved significantly in all but the first follow‐up period. For the indicator: ‘antimicrobial assessed by antimicrobial specialists as unnecessary’, improvement was statistically significant in the first (−4.7%, 95% CI −8.0, −1.4) and fourth (−4.2%, 95% CI −7.7%, −0.8%) periods. Service evaluation showed support for the pharmacist‐led stewardship activities. Conclusions There were significant and sustained improvements in prescribing quality as a result of the intervention. Consultants' engagement and acceptance of stewardship activities were demonstrated.