Affiliation:
1. Department of Clinical Pharmacy, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran
Abstract
Introduction:
This study was designed to evaluate the sustainability of the impact of
educational programs provided by pharmacists on the appropriateness of surgical antibiotic
prophylaxis and cost-savings in a short time and a long time after the intervention.
Methods and Materials:
This prospective educational interventional study was conducted in a tertiary
referral hospital for surgery in the West of Iran from September 2018 to October 2019. The
study was designed in three phases: pre-intervention phase, short term after the intervention, and
six months after the intervention. Within a one month course, several educational sessions regarding
the appropriate preoperative antibiotic prophylaxis based on the recommendations of the American
Society of Health-System Pharmacists guideline (ASHPs) were provided by a clinical pharmacist
in an interactive manner for the surgeons. The appropriateness of antibiotic prophylaxis regarding
the necessity for surgical antibiotic prophylaxis use (indication), the choice of antibiotic,
the timing of antibiotic administration, the route of administration, the dose of antibiotics, and the
total duration of antibiotic prophylaxis were evaluated and compared before and after the educational
intervention. Additionally, medication-related costs, non-medication-related costs, antibiotic
prophylaxis-related costs, and total costs of care were also assessed before and after the educational
intervention.
Results:
Our survey showed that total adherence to the guideline recommendations among surgeons
in our center was relatively low, and in 71.8% of procedures, at least in one of the quality
indicators, non-adherence to the guideline recommendations was observed. After the educational
intervention, a significant improvement in the rationality of antibiotic prophylaxis, in terms of not
administrating antibiotic prophylaxis in procedures without indication, appropriate timing of administration,
appropriate antibiotic dose, and appropriate duration of antibiotic prophylaxis, especially
in the short time after the intervention was observed that ultimately reduced the medication,
non-medication, antibiotic prophylaxis related, and total therapeutic costs.
Conclusions:
Our survey showed that educational interventions provided by pharmacists in an interactive
manner could improve guideline recommendations’ adherence among surgeons, particularly
in a short time. Thus, continuous education still should be considered an essential element of
a multifaceted intervention for improving guideline adherence.
Funder
Hamadan University of Medical Sciences, Hamadan, Iran
Publisher
Bentham Science Publishers Ltd.
Subject
Pharmacology (medical),Pharmacology,Toxicology