Program Schedule

202
Antifungal Stewardship: The Clinician’s Perspective on Barriers to Implementation

Session: Poster Abstract Session: Antibiotic Stewardship
Thursday, October 9, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • AFSPoster_Safdar_IDWeek2014.pdf (665.2 kB)
  • Background: The presence of invasive fungal infections (IFIs) significantly increases morbidity and mortality for patients with immune suppression. Incorporating antifungal stewardship (AFS) principles into clinical practice through a multidisciplinary approach can maximize the efficient use of antifungals and maximize improved patient outcomes by directing appropriate patients to receive timely antifungal therapy. Additionally, stewardship interventions and guidance can favorably impact hospital and pharmacy costs associated with antifungal overuse. A survey was designed to identify barriers influencing implementation and utilization of AFS strategies.

    Methods: A survey of 267 pharmacists and physicians was conducted to characterize perspectives on the value, approach and robustness of AFS strategies and programs in their hospitals. Additionally, they were asked to specify barriers to implementing an AFS program at their institution.

    Results: Only 35% of respondents strongly agreed (a rating of 6 or 7 on a 7-point scale) that their institution valued the benefits of AFS. Less than one quarter of respondents (23%) strongly agreed that their institution had a robust AFS program in place. Additionally, only 32% strongly agreed that their institution took a multidisciplinary approach to AFS. The top 3 barriers to successful implementation of AFS were identified as: 1) lack of awareness of need and/or benefit of AFS (37%); 2) limited time/compensation for AFS efforts (31%); and 3) lack of physician participation (27%).

    Conclusion: The survey results demonstrate the existing system-level limitations for successful implementation of AFS. Multilevel education regarding potential benefits of a robust AFS program and its impact on patient outcomes may favorably influence these limitations.

    Amar Safdar, MD, Infectious Diseases and Immunology, New York University Langone Medical Center, New York, NY, Debra Goff, PharmD, FCCP, College of Pharmacy, The Ohio State University, Columbus, OH, Jason Gallagher, PharmD, FCCP, BCPS, Temple University, Philadelphia, PA, Donald Hsu, PharmD, Western University College of Pharmacy, Pomona, CA, Edward Eiland, PharmD, MBA, BCPS-ID, FASHP, Vital Care, Inc., Meridian, MS, Jennifer Hanrahan, DO, Metrohealth Medical Center, Case Western University, Cleveland, OH, Purvi Smith, MS, MPH, Health and Wellness Partners, Ramsey, NJ and Nkechi Azie, MD, Astellas Scientific and Medical Affairs, Inc., Northbrook, IL

    Disclosures:

    A. Safdar, Astellas: Consultant and Speaker's Bureau, Consulting fee and Speaker honorarium
    Cubist: Speaker's Bureau, Speaker honorarium

    D. Goff, Astellas: Speaker's Bureau, Speaker honorarium
    Merck: Speaker's Bureau, Speaker honorarium
    Cubist: Research Contractor, Research support

    J. Gallagher, Cubist: Consultant, Consulting fee
    Optimer: Scientific Advisor and Speaker's Bureau, Consulting fee and Speaker honorarium
    Astellas: Speaker's Bureau, Speaker honorarium
    Forest: Scientific Advisor and Speaker's Bureau, Consulting fee and Speaker honorarium
    Pfizer: Scientific Advisor, Consulting fee

    D. Hsu, Cubist: Consultant and Speaker's Bureau, Consulting fee and Speaker honorarium
    Astellas: Speaker's Bureau, Speaker honorarium
    Merck: Speaker's Bureau, Research support and Speaker honorarium

    E. Eiland, Astellas: Speaker's Bureau, Speaker honorarium
    Cubist: Speaker's Bureau, Speaker honorarium

    J. Hanrahan, None

    P. Smith, Health and Wellness Partners: Employee, Salary

    N. Azie, Astellas: Employee, Salary

    Findings in the abstracts are embargoed until 12:01 a.m. EDT, Oct. 8th with the exception of research findings presented at the IDWeek press conferences.

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