Impact of non-medical prescribers on AMS and AMR should not be overlooked

We read with interest the article ’Pharmacist independent prescribers can make a significant contribution to antimicrobial stewardship’ by Hodson, Deslandes and Courtenay M (
The Pharmaceutical Journal 2017;298:313).

We too strongly believe that the impact of pharmacist non-medical prescribers on antimicrobial stewardship (AMS) and antimicrobial resistance (AMR) should not be overlooked. The 2013 General Pharmaceutical Council Prescribers Survey Report indicated that antibiotics were the most frequently prescribed medicine, with 39% of respondents stating that they prescribed antibiotics within their scope of practice, and, in 2013, Public Health England launched the ‘Antimicrobial prescribing and stewardship competencies’^[1]
,[2]
.

In December 2016, at the University of Manchester, we undertook a survey of 21 pharmacist and nurse independent prescribers who successfully completed our 2014/15 independent prescribing courses or taught on the course. The aim was to determine the understanding of the perceptions of pharmacist and nurse independent prescribers regarding the issues of AMS and AMR.

Thirty-three percent of respondents described that they felt that their independent prescribing course did not prepare them well in terms of knowledge of AMS and AMR, although we did not assess their baseline understanding of these issues prior to starting the course. Fifty-seven percent of respondents prescribed antimicrobials as part of their scope of prescribing practice, and 56% of these individuals undertook additional CPD courses, such as in-house training and distance learning courses on AMS and AMR.

With the predicted increase in numbers of non-medical prescribers and accordingly those who will prescribe antimicrobials, we believe that there is a need for good initial training in the independent prescribing courses on AMS and AMR, in addition to opportunities for high-quality post-course CPD post to maintain safe, effective prescribing of antimicrobials by non-medical prescribers.

Ms Negin Sardashti, MPharm student

Dr David Allison, reader in microbiology and pharmacy education

Mrs Sandra Martin, clinical academic lecturer

University of Manchester