Assessing the efficacy of pharmacist-engaged interventions in influencing antibiotic prescribing behavior among general practitioners: meta-analysis

Background: A meta-analysis study was undertaken to examine antibiotic resistance, specifically by assessing the effectiveness of pharmacist interventions in influencing the rate of antibiotic prescriptions compared to their impact on adherence to antibiotic prescribing guidelines. Objective: Evaluating the effectiveness of pharmacist interventions in influencing the rate of antibiotic prescriptions, in contrast to their impact on adherence to antibiotic prescribing guidelines. Method: A comprehensive literature review up to the year 2016 was conducted, examining a total of 215 relevant studies. Among these, 15 specific studies were chosen for inclusion, encompassing a population of 298,339 individuals who initially demonstrated antibiotic resistance. Within this group, 134,004 individuals were exposed to interventions involving pharmacist participation, while 164,335 served as controls. The calculation of odds ratios (OR) and 95% confidence intervals (CIs) was employed to assess antibiotic resistance in pharmacists involved in antibiotic prescribing rates as compared to those involved in antibiotic prescribing adherence rates. This analysis utilized dichotomous approaches and employed both fixed and random models. Result: When pharmacists participated in interventions targeting antibiotic prescribing rates, a considerable reduction in antibiotic resistance was observed (Odds Ratio, 0.86; 95% Confidence Interval, 0.78-0.95, p<0.00001). However, these findings exhibited a significant degree of heterogeneity (I2 = 90%). Conversely, in interventions focusing on improving antibiotic prescribing adherence rates involving pharmacists, a substantial increase in antibiotic resistance was noted (Odds Ratio, 1.96; 95% Confidence Interval, 1.56-2.45, p<0.00001), with similarly high heterogeneity in the results (I2 = 91%). These outcomes were specifically evident in individuals grappling with antibiotic resistance issues. Conclusion: Pharmacist-led interventions targeting antibiotic prescribing rates led to a noteworthy decrease in antibiotic resistance compared to scenarios without pharmacist involvement in such interventions. Nonetheless, it is crucial to approach the interpretation of these results with caution, given the limited sample size in certain studies incorporated into the meta-analysis.