'Perceptions and current practices of community pharmacists regarding antimicrobial stewardship in Tasmania

Background: Despite increasing interest in antimicrobial stewardship (AMS), little is known about the related practices andperceptions of community pharmacists. Objective: To develop and validate a questionnaire to measure the current practicesof, and barriers to community pharmacists’ participation in AMS. Setting: Community pharmacists in Tasmania, Australia.Method: A questionnaire to explore AMS knowledge, current practices and perceptions of community pharmacists was developed.It was designed after rigorous literature review, expert opinion, and feedback from a group of community pharmacists.A convenience sample of 140 Tasmanian community pharmacists was used for this study. Cronbach’s alpha and exploratoryfactor analysis (EFA) were used for reliability and validity. The questionnaire was hosted online, a link to which was sentby invitation e-mails, fax and post to community pharmacists in Tasmania, Australia. Main outcome measure: Current AMSpractices, perceived importance, barriers and facilitators of AMS. Results: Eighty-fve pharmacists responded to the surveyyielding a response rate of 61%. EFA identifed one factor solution for each of three perceptions scales and showed acceptablereliability. The Cronbach’s alpha of perceived importance-understanding was 0.699, perceived importance-motivatingwas 0.734, perceived support from GPs was 0.890, operational barriers was 0.585, general facilitators was 0.615. Mostpharmacists reported that they counselled patients on adverse efects (86%), drug interactions (94%), and allergies (96%).In contrast, less than half (43%) intervened with prescribers regarding antibiotic selection. Lack of training, lack of accessto patients’ records, limited interactions with general practitioners and absence of a reimbursement model were major barrierslimiting community pharmacists’ participation in AMS. Conclusion: The questionnaire was of acceptable reliability andvalidity; a larger study will further contribute in its reliability and validity. Future studies utilising the questionnaire at nationaland international level may provide further insights into the determinants of community pharmacist’s involvement in AMS