Moving Antimicrobial Stewardship Into Community Pharmacy: A Pre-post Study of Acute Otitis Media Management
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 188
- 试验地点
- 4
- 主要终点
- Change in guideline congruence
研究概览
简要总结
Acute otitis media (AOM) is the most common indication for antibiotics for Canadian paediatric patients. As the gatekeepers of safe and effective prescription pharmacotherapy, community pharmacists are well positioned to influence and optimize antibiotic use. The purpose of this project is to develop, implement, and evaluate an antimicrobial stewardship program in the community pharmacy setting that aims to optimize antibiotic use for AOM. This nonrandomized pre-post study includes children aged 6 months to 12 years presenting with an antibiotic prescription for AOM at two community pharmacies in Toronto, Ontario. Participants are excluded if they exhibit signs/symptoms of mastoiditis, have an additional indication for systemic antibiotics, or parents/guardians cannot consent in English. The multifaceted AMS intervention includes pharmacist education, a clinical decision support tool, a parent/guardian questionnaire, and individualized monthly audit and feedback with each pharmacist. Prescriptions are reviewed and adapted by the pharmacist to optimize congruence with 2016 Canadian Paediatric Society AOM guidelines. The primary outcome is the percentage change in guideline congruence attributable to pharmacist intervention. This study will provide insight into the opportunities and barriers of developing large-scale antimicrobial stewardship programs for community pharmacies.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Single Group
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 6 Months 至 12 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Prescribed systemic oral antibiotic therapy
- •Antibiotics are indicated for the treatment of acute otitis media (AOM) as reported verbally or in writing by parent/guardian or prescriber
排除标准
- •signs/symptoms of mastoiditis
- •a diagnosis in addition to AOM for which systemic antibiotics are indicated
- •parents/guardians cannot consent to the study in English
结局指标
主要结局
Change in guideline congruence
时间窗: Pre-post study intervention (comparison of two 4-6 month periods)
% change in guideline congruence for overall antibiotic prescriptions as attributable to pharmacist intervention before and after study intervention
次要结局
- Choice of antibiotic(Pre-post study intervention (comparison of two 4-6 month periods))
- Antibiotic dosing(Pre-post study intervention (comparison of two 4-6 month periods))
- Antibiotic duration(Pre-post study intervention (comparison of two 4-6 month periods))
- Acceptance of pharmacist recommendations(Post-intervention study arm (6 month period after start of intervention))
- Balancing measure: resolution of AOM(7-14 days after antibiotics were dispensed)
研究者
Katherine Koroluk
Principal Investigator
University of Toronto