The Effect of a Pharmacist-Led Educational Intervention on Rational Antibiotic Prescribing in an Outpatient Emergency Department

Abstract

Background: Educational interventions are effective methods for promoting knowledge and awareness among physicians to reduce irrational antibiotic prescriptions. Objectives: This study was designed to evaluate the effect of an educational intervention conducted by pharmacists on rational antibiotic prescribing in an outpatient emergency department (ED). Methods: This pre-post pilot intervention study was conducted in the outpatient ED of Shahid Bahonar Hospital, affiliated with Kerman University of Medical Sciences, Kerman, Iran, from February to June 2020. Non-random (convenience) sampling was used. All patients sent to the outpatient ED at triage who were prescribed antibiotics were included in this study. The pre-intervention phase was observational, during which a pharmacist assessed irrational antibiotic prescriptions over one month. Educational topics were determined based on the most common diagnoses related to irrational antibiotic prescriptions, in consultation with a clinical pharmacist and an infectious disease specialist. An educational video was then prepared and provided to the doctors prescribing antibiotics. Subsequently, the post-intervention phase was conducted in the same manner as the pre-intervention phase for one month. Results: During the pre-intervention phase, out of 314 prescriptions, 100 (31.85%) contained antibiotics. In the post-intervention phase, among a total of 235 prescriptions, 100 (42.55%) contained antibiotics. The mean age of the patients was 36.65 ± 15.73 years in the first phase and 37.30 ± 15.71 years in the second phase. Analyses revealed that the educational intervention had a statistically significant effect on reducing irrational antibiotic prescribing with respect to indication (P = 0.0001), dose (P = 0.005), and duration (P = 0.0001). Conclusions: The pharmacists’ educational intervention effectively reduced irrational antibiotic prescribing in the outpatient ED.