Hospital pharmacist workforce plan for antimicrobial resistance management

Abstract

Antimicrobial resistance (AMR) is recognized as a serious global health threat. Therefore, the National Strategic Plan on Antimicrobial Resistance (NSP-AMR) 2017–2021 was endorsed by the cabinet to tackle the problem in Thailand. The Integrated AMR Management (IAM) was introduced for hospitals to identify and address AMR problems. A hospital pharmacist is a member of the multidisciplinary team who plays an important role in the IAM. The objectives of this study were to explore AMR management in hospitals and to identify the number of hospital pharmacists required for AMR management in tertiary hospitals. Self-administered questionnaires were sent to 1,298 hospitals across Thailand. The questionnaire consisted of four parts: hospital characteristics; pharmacist characteristics; AMR activity implementation; and a pharmacist's perspective on AMR management. Data were collected between April and July 2021. Two hundred forty-nine hospital pharmacists completed the questionnaires (response rate 19.2%). Descriptive statistics, inferential statistics, and workload analysis were used to analyze data. Findings indicated that audit and feedback system, advising on dose adjustment, and purchasing antimicrobial drugs were common AMR management activities carried out by hospital pharmacists. The majority were optimistic about AMR management. In terms of full-time equivalent (FTE), the number of hospital pharmacists required for AMR management in tertiary hospitals was between 1.25 and 2.08 FTEs per hospital based on the level of hospitals. It could be concluded that a minimum of one FTE per hospital was recommended for efficient AMR management implementation. IMPLICATION OF THE THESIS: These findings could be presented to the Ministry of Public Health for consideration of allocating at least one FTE per hospital to the implementation of AMR management. A lack of specialized pharmacists may be alleviated by short course training programs and on-the-job training. Thus, pharmacists could increase their proficiency in operating the Antimicrobial Resistance stewardship program in hospitals.