Early review of intravenous (IV) antimicrobial therapy is central to antimicrobial stewardship (AMS), however scalable models for general medical patients are limited. We evaluated a pharmacist-led digital intervention to optimize IV antimicrobial prescribing.

A prospective, quasi-experimental before-and-after study was conducted between May 2022 to February 2023 across six general medicine units at a tertiary hospital. AMS recommendations were delivered electronically via Microsoft Teams®. Adult inpatients receiving IV antimicrobials for >24 hours were included, excluding those with COVID-19, under Infectious Diseases consultation or receiving palliative care. The primary outcome was median IV antimicrobial duration. Secondary outcomes included AMS recommendation type, recommendation acceptance, length of stay (LOS), 30-day infection-related readmission, IV therapy recommencement, and inpatient mortality. Antibacterial consumption was analyzed from July 2021 to through December 2024 to evaluate sustained impact.

Among 723 antimicrobial orders (474 treatment episodes in 458 patients), median IV duration was comparable between phases (intensive: 2.75 days; baseline: 3.00 days). LOS was shorter during the intensive phase compared to baseline (5.5 vs 7.6 days; P = .04), particularly in patients without bacteremia. Readmissions and mortality were unchanged. Of 400 AMS recommendations, 67% were IV-to-oral switches; overall acceptance was 78%. Piperacillin-tazobactam use declined, and sustained reductions in aminoglycosides, ampicillin and IV flucloxacillin were observed. A reduction in total antibiotic prescribing (combined IV and oral prescribing) was also observed.

The digital pharmacist-led AMS intervention did not reduce IV duration, likely reflecting strong baseline prescribing, but was associated with shorter LOS and a reduction in total antibacterial use. This program offered a scalable, sustainable alternative to resource-intensive face-to-face models.

Front-of-Package Labelling informs consumers about the ‘healthiness’ of foods based on different classification schemes. These schemes reflect competing worldviews for assessing a food’s healthiness, represented by nutrient-, food-, or diet-based indices. The Health Star Rating scheme (HSR) has been criticised for failing to appropriately score unhealthy products. Updates to the HSR algorithm were implemented over a two-year period from November 2020. This study investigated alignment between a nutrient-based scheme (HSR), food-based scheme (Nova food processing system), and diet-based scheme (Australian Dietary Guidelines (ADGs)).

Mintel Global New Products Database

Retail foods displaying HSRs launched or updated onto the Australian market between November 2020 and June 2023.

Products were categorised according to the ADGs and Nova, descriptive statistics performed for each category, and proportion displaying HSRs ≤2.0 and ≥2.5 calculated for discretionary foods, Five Food Group foods, ultra-processed foods (UPFs) and non-UPFs. Agreement between categories obtained by Kappa.

Median HSRs for UPFs and discretionary foods were 3.5 and 2.5 respectively, and 73.7% of UPFs and 58.2% of discretionary foods displayed HSRs ≥2.5. Agreement between HSR and Nova was none to slight (k=0.09, p<0.001); and HSR and ADGs, fair (k=0.38, p<0.001). Between 2020-2023, the proportion of UPFs displaying HSRs ≥2.5 increased from 60.2% to 78.5%; and for discretionary foods, 47.0% to 62.5%.

The HSR algorithm calculates ‘healthy’ HSRs (≥2.5) for a high proportion of UPFs and discretionary foods. The HSR’s nutrient-based approach to translate food- and diet-based nutrition recommendations into accurate food ‘healthiness’ assessments is still problematic.

This study aims to assess the perspectives of patients with chronic conditions on the use of the Assessment of Burden of Chronic Conditions (ABCC) tool during consultations with their healthcare providers in primary care.

The increasing prevalence of chronic conditions, including multimorbidity, poses major challenges to healthcare systems today, particularly in primary care where most chronic care takes place. Effective management strategies are crucial for improving quality of life (QoL). The ABCC tool offers a unique approach to chronic disease management by facilitating shared decision-making and self-management.

This qualitative phenomenological study involved semi-structured interviews. Fourteen patients with chronic obstructive pulmonary disease (COPD), asthma, type 2 diabetes mellitus (T2DM) and/or chronic heart failure (CHF) were recruited from a previously conducted quasi-experimental study on the effectiveness of the ABCC tool.

Participants generally expressed satisfaction with the comprehensive questionnaire, user-friendly design and clear visualisation. They appreciated the opportunity to facilitate discussions with healthcare providers and help with monitoring. However, some confusion around the grey balloons in the tool highlighted the need for clearer explanations. Participants had limited awareness of advanced treatment recommendation functions.

This study provides valuable insights into patients’ experiences with the ABCC tool. Despite challenges such as recall bias and limited awareness of certain features, participants generally expressed satisfaction with using the tool. Based on these findings, the tool can be further improved and its use should be further supported. However, the ABCC tool shows promise as a valuable instrument for improving consultations in clinical practice.