130 - Antimicrobial Stewardship Practices in Community Pharmacies Across the United States

Background: Antimicrobial stewardship (AMS) in the community is essential as majority of antibiotic prescribing occurs in the community. Pharmacists are recognized by the Center for Disease Control and Prevention (CDC) as co-leaders for leading implementation efforts to improve antibiotic use. The purpose of this study is to evaluate current AMS practices in community pharmacies across the United States (US) and identify challenges.

Methods: A 15-item survey was created based on CDC’s Core Elements of Outpatient AMS to assess current policies and practices in place, as well as collect baseline demographics and pharmacists’ perceptions. A survey invite was posted on the Facebook group, Pharmacist Moms, in September 2019. Participation was voluntarily and anonymous.

Results: Participants included 61 community pharmacists from 25 states across the US. 88.5% work in a chain pharmacy with 54.1% in staff positions and 37.7% in management. 37.7% have been practicing for > 10 years, 36.1% for 6-10 years and 26.2% 5 or less years. Minimal responses met CDC’s Core Elements of AMS: commitment (27.9%), action (24.6%), tracking and reporting (14.8%), and education and expertise (23% for pharmacists, 9.8% for patients).
In regards to perception, 67.9% felt AMS is important in the community. 88.5% would participate in AMS if the opportunity were provided. 91.8% were unsure or had no plans to implement AMS within the next 2 years.
Common challenges include the lack of time/staff (83.6%), pushback from prescribers (68.9%), lack of leadership (57.4%), lack of financial incentives (52.5%), pushback from patients (52.5%), lack of pharmacist knowledge/training (39.3%), lack of funding/financial support (29.5%), lack of legal requirement (21.3%), lack of information technology support (19.7%), and lack of pharmacist interest (11.5%).Current Trends of U.S. Community Pharmacies in Meeting CDC's Core Elements of Outpatient Antimicrobial Stewardship
Challenges in Implementing Antimicrobial Stewardship in Community Pharamacies


Conclusion: Results from this study reveal the lack of AMS practices in community pharmacies. Pharmacists have a critical role in AMS, but many challenges exist in the community setting inhibiting the full potential of pharmacists in AMS efforts. This study highlights the importance and need for addressing these issues as regulations and strategies for AMS in community settings develop.