Impact of pharmacist-prescriber partnerships to track antibiotic prescribing in publicly funded primary care in the Cape Town metropole, South Africa: An implementation study
Background. More than 80% of the South African (SA) population receive their care in publicly funded primary care clinics. The majority come from socioeconomically disadvantaged communities, and bear the greatest burden from infectious diseases. However, there are very limited published data on...
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South African Medical Association
2024-11-01
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| Series: | South African Medical Journal |
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| Online Access: | https://samajournals.co.za/index.php/samj/article/view/1914 |
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| author | O Van Hecke Y Adegoke M Allwood K von Pressentin M Namane C Butler M Mendelson R Coetzee |
| author_facet | O Van Hecke Y Adegoke M Allwood K von Pressentin M Namane C Butler M Mendelson R Coetzee |
| author_sort | O Van Hecke |
| collection | DOAJ |
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Background. More than 80% of the South African (SA) population receive their care in publicly funded primary care clinics. The majority come from socioeconomically disadvantaged communities, and bear the greatest burden from infectious diseases. However, there are very limited published data on and evaluation of antibiotic prescribing linked to clinical indication. This is a major gap.
Objectives. To assess the impact of a pharmacist-prescriber partnership to track antibiotic prescribing in publicly funded primary healthcare clinics in the Cape Town metropole, SA.
Methods. We conducted a prospective observational study across five clinics where there was a dispensing pharmacist team. At each clinic, a prescriber-pharmacist team gathered prospective antibiotic prescribing data for ‘acute cough’, linked to clinical indication, and provided individual prescribing feedback through each clinic’s WhatsApp messaging platform about their prescribing quality (antibiotic dose, duration, frequency).
Results. Eight out of every 10 patients (adults and children) were prescribed an antibiotic (n=457). In a third of patients, an antibiotic was prescribed for suspected ‘community-acquired pneumonia’. The WhatsApp prescribing feedback was used in half of all visits. The proportion of pharmacy-dispensed antibiotics concordant with local guidelines in terms of prescribing quality was 95% (95% confidence interval 0.93 - 0.98), n=239). Against AWaRe (access/watch/reserve) guidance, 97% of antibiotics prescribed belonged to the ‘access’ group.
Conclusion. Although prescribing concordance with guidelines was good, a significant proportion of patients were prescribed an antibiotic for ‘acute cough’. Our findings have filled a fundamental gap in the evidence base that will inform antibiotic stewardship innovations, guideline development and future interventions.
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| format | Article |
| id | doaj-art-8f24e8a481c94cde95811acf36fe8268 |
| institution | Kabale University |
| issn | 0256-9574 2078-5135 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | South African Medical Journal |
| spelling | doaj-art-8f24e8a481c94cde95811acf36fe82682025-02-10T12:25:30ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352024-11-011141210.7196/SAMJ.2024.v114i12.1914Impact of pharmacist-prescriber partnerships to track antibiotic prescribing in publicly funded primary care in the Cape Town metropole, South Africa: An implementation studyO Van Hecke0Y Adegoke1M Allwood2K von Pressentin3M Namane4C Butler5M Mendelson6R Coetzee7Centre for General Practice, Department of Public Health and Primary Care, Ghent University, BelgiumSchool of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South AfricaNuffield Department of Primary Care Health Sciences, University of Oxford, UKDivision of Family Medicine, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, South Africa Division of Family Medicine, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, South AfricaNuffield Department of Primary Care Health Sciences, University of Oxford, UKDivision of Infectious Disease and HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, South AfricaSchool of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa Background. More than 80% of the South African (SA) population receive their care in publicly funded primary care clinics. The majority come from socioeconomically disadvantaged communities, and bear the greatest burden from infectious diseases. However, there are very limited published data on and evaluation of antibiotic prescribing linked to clinical indication. This is a major gap. Objectives. To assess the impact of a pharmacist-prescriber partnership to track antibiotic prescribing in publicly funded primary healthcare clinics in the Cape Town metropole, SA. Methods. We conducted a prospective observational study across five clinics where there was a dispensing pharmacist team. At each clinic, a prescriber-pharmacist team gathered prospective antibiotic prescribing data for ‘acute cough’, linked to clinical indication, and provided individual prescribing feedback through each clinic’s WhatsApp messaging platform about their prescribing quality (antibiotic dose, duration, frequency). Results. Eight out of every 10 patients (adults and children) were prescribed an antibiotic (n=457). In a third of patients, an antibiotic was prescribed for suspected ‘community-acquired pneumonia’. The WhatsApp prescribing feedback was used in half of all visits. The proportion of pharmacy-dispensed antibiotics concordant with local guidelines in terms of prescribing quality was 95% (95% confidence interval 0.93 - 0.98), n=239). Against AWaRe (access/watch/reserve) guidance, 97% of antibiotics prescribed belonged to the ‘access’ group. Conclusion. Although prescribing concordance with guidelines was good, a significant proportion of patients were prescribed an antibiotic for ‘acute cough’. Our findings have filled a fundamental gap in the evidence base that will inform antibiotic stewardship innovations, guideline development and future interventions. https://samajournals.co.za/index.php/samj/article/view/1914Primary careantimicrobial stewardshipacute respiratory infections |
| spellingShingle | O Van Hecke Y Adegoke M Allwood K von Pressentin M Namane C Butler M Mendelson R Coetzee Impact of pharmacist-prescriber partnerships to track antibiotic prescribing in publicly funded primary care in the Cape Town metropole, South Africa: An implementation study South African Medical Journal Primary care antimicrobial stewardship acute respiratory infections |
| title | Impact of pharmacist-prescriber partnerships to track antibiotic prescribing in publicly funded primary care in the Cape Town metropole, South Africa: An implementation study |
| title_full | Impact of pharmacist-prescriber partnerships to track antibiotic prescribing in publicly funded primary care in the Cape Town metropole, South Africa: An implementation study |
| title_fullStr | Impact of pharmacist-prescriber partnerships to track antibiotic prescribing in publicly funded primary care in the Cape Town metropole, South Africa: An implementation study |
| title_full_unstemmed | Impact of pharmacist-prescriber partnerships to track antibiotic prescribing in publicly funded primary care in the Cape Town metropole, South Africa: An implementation study |
| title_short | Impact of pharmacist-prescriber partnerships to track antibiotic prescribing in publicly funded primary care in the Cape Town metropole, South Africa: An implementation study |
| title_sort | impact of pharmacist prescriber partnerships to track antibiotic prescribing in publicly funded primary care in the cape town metropole south africa an implementation study |
| topic | Primary care antimicrobial stewardship acute respiratory infections |
| url | https://samajournals.co.za/index.php/samj/article/view/1914 |
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