Community pharmacy staff ‘essential’ in promoting antimicrobial stewardship, says NHS England

NHS England said its findings in a report highlighted the “essential clinical role” community pharmacy teams have in educating the public to ensure appropriate use of antibiotics.
patient collecting prescription

Community pharmacy staff have an “essential clinical role” in ensuring the safe and appropriate use of antibiotics, a report by NHS England has concluded.

The report, published on 30 May 2023, evaluated the Pharmacy Quality Scheme’s (PQS) antimicrobial stewardship (AMS) requirements from 2020/2021 to 2021/2022, including the use of TARGET antibiotic checklists.

The checklist is designed to be used by pharmacy teams with patients who are waiting to collect antibiotics.

As part of the PQS in 2021/2022, pharmacies were incentivised to submit at least 25 checklists within four weeks, with 8,374 pharmacies submitting data from 213,105 TARGET antibiotic checklists during the data collection period that year, the report said.

Some “62,544 (30%) checklists were completed for patients with a respiratory tract infection; 43,093 (21%) for a urinary tract infection; and 30,764 (15%) for tooth/dental infections,” it added.

“The TARGET Antibiotic Checklist aims to facilitate targeted information sharing between the patient and pharmacist to address concerns and give appropriate counselling.”

The report found that patients most frequently requested further information from the pharmacy team about side effects of their antibiotics (16.6%, n = 34,560), how to take their antibiotics with food (15.5%, n = 32,247) and how long their symptoms would last (15.5%, n = 32,247).

Among the four recommendations set out in the report for community pharmacy teams, NHS England said they should “continue to act as antimicrobial stewards and promote antimicrobial stewardship” by becoming antibiotic guardians.

“Our findings further highlight and recognise the essential clinical role that community pharmacy staff have in AMS activities and collaborative working with other primary care colleagues, as well as ongoing and continued public education to ensure the safe and appropriate use of antibiotics,” the report said.

“These AMS initiatives and findings form a solid foundation of knowledge and experience for community pharmacy to build on as the Pharmacy First service is introduced.”

In May 2023, the government announced plans to set up a ‘Pharmacy First’ service in England, allowing pharmacists to supply medicines for seven common health conditions, including earache, sore throat and urinary tract infections.

However, senior academics wrote an open letter to prime minister Rishi Sunak in the same month, expressing concern about the possibility of “extremely serious unintended consequences” of the new service, related to antimicrobial resistance.

Diane Ashiru-Oredope, lead pharmacist for antimicrobial resistance and stewardship at the UK Health Security Agency (UKHSA), said community pharmacy teams “have an important role in addressing antimicrobial resistance and encouraging the prudent use of antimicrobials”.

“They play pivotal roles in counselling patients and promoting AMS. They can also provide infection prevention messages, screening, referral, disposal, and treatment options in the pharmacy, as well as lead on quality improvements and innovation in pharmacy practice,” she said.

“We welcome the recommendations of the report. UKHSA will continue to lead and support the development of AMS evidence-based tools for community pharmacy teams.”

Under the PQS for 2023/2024, pharmacies are again incentivised to submit at least 25 checklists over four weeks, as well as being incentivised to undertake training on the safe disposal of antibiotics.

Last updated
The Pharmaceutical Journal, PJ, June 2023, Vol 310, No 7974;310(7974)::DOI:10.1211/PJ.2023.1.187649

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