Validation of a Questionnaire for Patient Awareness and the Need for a Community-Based Outpatient Antimicrobial Stewardship Program (O-ASP): A Pilot Study.

Sohyun Park,Chung-Jong Kim,Sandy Jeong Rhie,Eun Kyoung Chung,Won Gun Kwack,Hee Jung Choi,Min Jeong Geum

doi:10.3390/antibiotics10040441

Abstract

An outpatient antimicrobial stewardship program (O-ASP) was developed and implemented to promote appropriate antibiotic therapy in outpatient settings. As active patient involvement is a critical component of an effective O-ASP, this study aimed to develop and validate a questionnaire addressing patient awareness for appropriate antibiotic therapy and the need for pharmaceutical care services (PCS) in the O-ASP in Korea. The questionnaire was drafted based on ASPs and PCS guidelines and validated for content and construct validity using the item-content validity index (I-CVI) and Cronbach’s alpha, respectively. The estimated I-CVI and Cronbach’s alpha were considered excellent or adequate (≥0.8 and 0.70–0.90, respectively) for most of the survey items (17 out of 23 items). The validated questionnaire was utilized in a pilot survey study, including 112 individuals (37% male) with the mean ± SD age of 37 ± 13 years. Among the survey participants, 68% responded that antibiotics had been prescribed appropriately; however, ≥50% showed a lack of knowledge regarding their antibiotic therapy. The participants expressed the need for PCS as part of an O-ASP in the questionnaire (average Likert score ≥3.4/5). In conclusion, our newly validated questionnaire successfully measured patient awareness and knowledge of antimicrobial use and the need for PCS in the O-ASP.

Highlights

Antibiotic resistance is recognized as one of the biggest threats to global public health [1]
The responses from the survey participants suggested that items 6, 13, 17, 23, 27, and 28 were items that were potentially difficult to answer due to the following reasons: (1) not knowing the name of individual antibiotics, (2) not understanding what preauthorization means, and (3) lack of knowledge regarding pharmaceutical care
In this study, we developed and validated a questionnaire assessing patient awareness of antimicrobial use and the need for community-based pharmaceutical care services (PCS) in the outpatient antimicrobial stewardship program (O-antimicrobial stewardship program (ASP)) based on ASP guidelines as well as PCS

Summary

Introduction

Antibiotic resistance is recognized as one of the biggest threats to global public health [1]. In the United States (US), at least 2.8 million patients are infected annually by an antibiotic-resistant microbial organism, resulting in more than 35,000 infection-related deaths [2]. In South Korea, antimicrobial resistance is a growing problem, with more than 50% of clinical Enterobacteriaceae isolates resistant to at least one antibiotic class [3]. The major risk factor for antibiotic resistance is the inappropriate use of antibiotics [4]. According to previous US studies, more than 50% of antibiotic prescription fills were inappropriate, including at least 30% of unnecessary outpatient antibiotic prescriptions [2,5,6]. A similar prevalence of inappropriate antibiotic use was reported in Korea (30–50%) [7,8]

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Discussion

Conclusion