Pharmacists combating antimicrobial resistance: A Delphi study on antibiotic dispensing

Area of Science:

• Pharmaceutical Sciences
• Public Health
• Pharmacy Practice

Background:

• Community pharmacists dispense antibiotics daily, but optimal practices for ensuring quality use are not well-defined.
• Understanding the specific roles and implementation feasibility of these roles is crucial for improving antibiotic stewardship.

Purpose of the Study:

• To define specific tasks for community pharmacists during antibiotic dispensing.
• To assess the practical implementation feasibility of these tasks across Europe.

Main Methods:

• A Delphi study involving 38 experts from 21 European Economic Area countries.
• Systematic literature review to identify potential pharmacist tasks, followed by three rounds of expert rating on importance and feasibility.
• Consensus defined as ≥80% agreement on importance (ratings 7-9).

Main Results:

• Consensus was reached on 108 tasks across five themes: prescriber collaboration, prescription checking, patient counseling, education, and pharmacy services.
• Key tasks include advising prescribers, safety checks, and patient counseling on antibiotics and antimicrobial resistance.
• Implementation feasibility consensus was only achieved for patient counseling and education; barriers include healthcare system structure, resistance to change, and lack of resources.

Conclusions:

• Community pharmacists are vital for effective antibiotic dispensing and stewardship.
• The study outlines essential tasks for improving antibiotic dispensing practices in European community pharmacies, highlighting areas for targeted interventions.