Antimicrobial stewardship interventions involving community pharmacy teams: a scoping review

The importance of involvement of community pharmacy (CP) teams in antimicrobial stewardship (AMS)-related interventions is justified by the high prevalence of antimicrobial prescribing in primary care. Yet, CP teams are rarely considered as part of AMS activities.

To synthesize the available evidence in relation to the current involvement of community pharmacists in AMS-related interventions involving CP team members.

To ensure rigour, the search followed the recommendations of the PRISMA-ScR and the protocol registered with the Open Science Framework. The search was conducted in MEDLINE, International Pharmaceutical Abstracts and CINAHL, identifying studies published between 1999 and 2023 and in English. Studies reporting AMS-related interventions, including at least one CP team member and conducted in a CP setting were included. Study selection and data extraction were performed by two independent reviewers.

Thirty-eight reports were included with pharmacists mainly using patient interviews (n = 26) and point-of-care testing (n = 15) as information sources to support patient assessment. Pharmacist interventions included providing patient counselling (n = 30) and referring to other healthcare professionals (n = 17). The main barrier for intervention implementation was the lack of or inadequate remuneration (n = 10); the easy accessibility of CPs was the predominant facilitator (n = 12). Only three of the included reports were underpinned by implementation theory.

The review is significant since it highlights CP interventions in an area where there is not much evidence. It emphasizes the need to remunerate CPs for their involvement in AMS while highlighting the potential for expansion of easily accessible CP services.