Antimicrobial Stewardship for a Geriatric Behavioral Health Population
Antimicrobial resistance is a growing public health concern. Antimicrobial stewardship and multi-disciplinary intervention can prevent inappropriate antimicrobial use and improve patient care. Special populations, especially older adults and patients with mental health disorders, can be particularly...
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Published in | Antibiotics (Basel) Vol. 5; no. 1; p. 8 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
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Switzerland
MDPI
19.01.2016
MDPI AG |
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Abstract | Antimicrobial resistance is a growing public health concern. Antimicrobial stewardship and multi-disciplinary intervention can prevent inappropriate antimicrobial use and improve patient care. Special populations, especially older adults and patients with mental health disorders, can be particularly in need of such intervention. The purpose of this project was to assess the impact of pharmacist intervention on appropriateness of antimicrobial prescribing on a geriatric psychiatric unit (GPU). Patients ≥18 years old prescribed oral antibiotics during GPU admission were included. Antimicrobial appropriateness was assessed pre- and post-pharmacist intervention. During the six-month pre- and post-intervention phase, 63 and 70 patients prescribed antibiotics were identified, respectively. Subjects in the post-intervention group had significantly less inappropriate doses for indication compared to the pre-intervention group (10.6% vs. 23.9%, p = 0.02), and significantly less antibiotics prescribed for an inappropriate duration (15.8% vs. 32.4%, p < 0.01). There were no significant differences for use of appropriate drug for indication or appropriate dose for renal function between groups. Significantly more patients in the post intervention group had medications prescribed with appropriate dose, duration, and indication (51% vs. 66%, p = 0.04). Pharmacist intervention was associated with decreased rates of inappropriate antimicrobial prescribing on a geriatric psychiatric unit. |
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AbstractList | Antimicrobial resistance is a growing public health concern. Antimicrobial stewardship and multi-disciplinary intervention can prevent inappropriate antimicrobial use and improve patient care. Special populations, especially older adults and patients with mental health disorders, can be particularly in need of such intervention. The purpose of this project was to assess the impact of pharmacist intervention on appropriateness of antimicrobial prescribing on a geriatric psychiatric unit (GPU). Patients ≥18 years old prescribed oral antibiotics during GPU admission were included. Antimicrobial appropriateness was assessed pre- and post-pharmacist intervention. During the six-month pre- and post-intervention phase, 63 and 70 patients prescribed antibiotics were identified, respectively. Subjects in the post-intervention group had significantly less inappropriate doses for indication compared to the pre-intervention group (10.6%
vs.
23.9%,
p
= 0.02), and significantly less antibiotics prescribed for an inappropriate duration (15.8%
vs.
32.4%,
p
< 0.01). There were no significant differences for use of appropriate drug for indication or appropriate dose for renal function between groups. Significantly more patients in the post intervention group had medications prescribed with appropriate dose, duration, and indication (51%
vs.
66%,
p
= 0.04). Pharmacist intervention was associated with decreased rates of inappropriate antimicrobial prescribing on a geriatric psychiatric unit. Antimicrobial resistance is a growing public health concern. Antimicrobial stewardship and multi-disciplinary intervention can prevent inappropriate antimicrobial use and improve patient care. Special populations, especially older adults and patients with mental health disorders, can be particularly in need of such intervention. The purpose of this project was to assess the impact of pharmacist intervention on appropriateness of antimicrobial prescribing on a geriatric psychiatric unit (GPU). Patients ≥18 years old prescribed oral antibiotics during GPU admission were included. Antimicrobial appropriateness was assessed pre- and post-pharmacist intervention. During the six-month pre- and post-intervention phase, 63 and 70 patients prescribed antibiotics were identified, respectively. Subjects in the post-intervention group had significantly less inappropriate doses for indication compared to the pre-intervention group (10.6% vs. 23.9%, p = 0.02), and significantly less antibiotics prescribed for an inappropriate duration (15.8% vs. 32.4%, p < 0.01). There were no significant differences for use of appropriate drug for indication or appropriate dose for renal function between groups. Significantly more patients in the post intervention group had medications prescribed with appropriate dose, duration, and indication (51% vs. 66%, p = 0.04). Pharmacist intervention was associated with decreased rates of inappropriate antimicrobial prescribing on a geriatric psychiatric unit. |
Author | Wong, Nicolas Liang, Eva Rubal-Peace, Georgina Ellis, Kristen Chang, Victoria Campbell, Stephanie |
AuthorAffiliation | 1 Banner Medical University Center South, 2800 E Ajo Way, Tucson, AZ 85713, USA; georgina.rubal-peace@bannerhealth.com 2 University of Arizona College of Pharmacy, 1295 N Martin PO Box 210202, Tucson, AZ 85721-0202, USA; chang@pharmacy.arizona.edu (V.C.); liang@pharmacy.arizona.edu (E.L.); nwong@pharmacy.arizona.edu (N.W.); scampbell@pharmacy.arizona.edu (S.C.) |
AuthorAffiliation_xml | – name: 2 University of Arizona College of Pharmacy, 1295 N Martin PO Box 210202, Tucson, AZ 85721-0202, USA; chang@pharmacy.arizona.edu (V.C.); liang@pharmacy.arizona.edu (E.L.); nwong@pharmacy.arizona.edu (N.W.); scampbell@pharmacy.arizona.edu (S.C.) – name: 1 Banner Medical University Center South, 2800 E Ajo Way, Tucson, AZ 85713, USA; georgina.rubal-peace@bannerhealth.com |
Author_xml | – sequence: 1 givenname: Kristen surname: Ellis fullname: Ellis, Kristen email: ellis@pharmacy.arizona.edu, ellis@pharmacy.arizona.edu organization: University of Arizona College of Pharmacy, 1295 N Martin PO Box 210202, Tucson, AZ 85721-0202, USA. ellis@pharmacy.arizona.edu – sequence: 2 givenname: Georgina surname: Rubal-Peace fullname: Rubal-Peace, Georgina email: georgina.rubal-peace@bannerhealth.com organization: Banner Medical University Center South, 2800 E Ajo Way, Tucson, AZ 85713, USA. georgina.rubal-peace@bannerhealth.com – sequence: 3 givenname: Victoria surname: Chang fullname: Chang, Victoria email: chang@pharmacy.arizona.edu organization: University of Arizona College of Pharmacy, 1295 N Martin PO Box 210202, Tucson, AZ 85721-0202, USA. chang@pharmacy.arizona.edu – sequence: 4 givenname: Eva surname: Liang fullname: Liang, Eva email: liang@pharmacy.arizona.edu organization: University of Arizona College of Pharmacy, 1295 N Martin PO Box 210202, Tucson, AZ 85721-0202, USA. liang@pharmacy.arizona.edu – sequence: 5 givenname: Nicolas surname: Wong fullname: Wong, Nicolas email: nwong@pharmacy.arizona.edu organization: University of Arizona College of Pharmacy, 1295 N Martin PO Box 210202, Tucson, AZ 85721-0202, USA. nwong@pharmacy.arizona.edu – sequence: 6 givenname: Stephanie surname: Campbell fullname: Campbell, Stephanie email: scampbell@pharmacy.arizona.edu organization: University of Arizona College of Pharmacy, 1295 N Martin PO Box 210202, Tucson, AZ 85721-0202, USA. scampbell@pharmacy.arizona.edu |
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Cites_doi | 10.1007/s11096-013-9875-8 10.1086/427507 10.1111/jgs.12323 10.1093/cid/ciq257 10.1093/cid/ciu444 10.1086/511159 10.1093/jac/dkt362 10.1136/bmj.317.7159.609 10.1086/651706 10.1086/522676 10.1086/420936 10.1001/jama.296.15.1858 |
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Keywords | pharmacist geriatric antimicrobial stewardship mental health |
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Title | Antimicrobial Stewardship for a Geriatric Behavioral Health Population |
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