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Effects of County Medical Community Central Pharmacy on antibiotic use in primary care: a multicenter quasi-experiment.

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Τίτλος: Effects of County Medical Community Central Pharmacy on antibiotic use in primary care: a multicenter quasi-experiment.
Συγγραφείς: Gao T; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, 250012, China.; Department of Pharmacy, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, China., Huang S; Hubei Industrial Polytechnic, Shiyan, 442000, China., Shen L; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, 250012, China., Yin J; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, 250012, China., Sun Q; Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China. qiangs@sdu.edu.cn.; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China. qiangs@sdu.edu.cn.; Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, 250012, China. qiangs@sdu.edu.cn.; China National Health Development Research Center, Beijing, 100000, China. qiangs@sdu.edu.cn.
Πηγή: International journal of clinical pharmacy [Int J Clin Pharm] 2025 Dec; Vol. 47 (6), pp. 1986-1996. Date of Electronic Publication: 2025 Oct 11.
Τύπος έκδοσης: Journal Article; Multicenter Study
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Springer Country of Publication: Netherlands NLM ID: 101554912 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2210-7711 (Electronic) NLM ISO Abbreviation: Int J Clin Pharm Subsets: MEDLINE
Imprint Name(s): Original Publication: Dordrecht : Springer
Ιατρικοί όροι (MeSH): Anti-Bacterial Agents*/therapeutic use , Anti-Bacterial Agents*/administration & dosage , Primary Health Care*/standards , Antimicrobial Stewardship*/methods , Community Pharmacy Services*/organization & administration , Community Pharmacy Services*/standards , Inappropriate Prescribing*/prevention & control , Practice Patterns, Pharmacists'*/standards, China/epidemiology ; Humans ; Male ; Female ; Pharmacists ; Middle Aged ; Adult
Περίληψη: Introduction: Antimicrobial resistance poses a growing global health threat and is largely driven by the inappropriate use of antibiotics. Primary healthcare institutions, particularly in low-resource settings, often face challenges, such as limited oversight and irrational prescribing practices. While progress has been made in improving antibiotic stewardship in higher-level hospitals, efforts to optimize prescription in primary healthcare institutions remain insufficient. The County Medical Community Central Pharmacy (CMCP) program was introduced as an integrated intervention to enhance pharmacy services and promote rational antibiotic use through centralized oversight, training, and pharmacist collaboration.
Aim: This multicenter quasi-experimental study aimed to evaluate the effectiveness of the CMCP program in reducing antibiotic misuse and improving prescribing rationality in primary healthcare institutions in Shandong Province, China.
Method: This multicenter quasi-experimental study was conducted between July and December 2023 in six geographically and economically diverse rural regions of Shandong Province. A total of 37 primary healthcare institutions were included, with 25 voluntarily implementing the CMCP program (intervention group) and 12 continuing routine practices (control group). Data were collected at two time points via structured questionnaires and reviews of 100 randomly selected outpatient prescriptions from each primary healthcare institution. A difference-in-differences (DID) regression model was applied to estimate the impact of the intervention on antibiotic usage and irrational prescribing, controlling for institutional and staffing characteristics.
Results: Antibiotic usage rates increased in both groups, but to a lesser extent in the intervention group (from 15.726 to 18.732%; P = 0.006) than in the control group (from 17.682 to 26.582%; P < 0.001). DID analysis showed a mitigating effect on antibiotic use (DID coefficient = - 0.061; P = 0.054). Irrational antibiotic use in the intervention group decreased from 50.660 to 27.655% (P < 0.001), whereas it remained largely unchanged in the control group (36.893% vs. 35.238%).
Conclusion: The CMCP program was effective in curbing unnecessary antibiotic prescriptions and enhancing prescription quality in primary healthcare institutions. These findings support the continued implementation and scale-up of CMCP as a strategy to strengthen antibiotic stewardship at the primary care level in resource-limited settings.
(© 2025. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethics approval: Ethical approval was granted by the Ethics Committee of the Centre for Health Management and Policy Research, Shandong University (18th December 2023, ECSHCMSDU20231201).
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Grant Information: 72174109 National Natural Science Foundation of China
Contributed Indexing: Keywords: Antimicrobial stewardship; China; County Medical Community Central Pharmacy; Drug utilization; Pharmacies; Primary health care; Quasi-experimental study
Substance Nomenclature: 0 (Anti-Bacterial Agents)
Entry Date(s): Date Created: 20251011 Date Completed: 20251119 Latest Revision: 20251215
Update Code: 20260130
DOI: 10.1007/s11096-025-02014-x
PMID: 41075025
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:2210-7711
DOI:10.1007/s11096-025-02014-x