Stewardship recommendations less likely to be followed when made by a woman, study finds
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Antibiotic timeouts conducted by women pharmacists were less likely to result in an antibiotic change than those conducted by men, according to data presented at the Society for Healthcare Epidemiology of America Spring Meeting.
“We were doing a qualitative study trying to understand perspectives of pharmacists involved in antibiotic stewardship and noticed that — although women wouldn’t directly cite gender bias as an issue — the language used to describe relationships with physicians was different between men and women pharmacists,” Valerie M. Vaughn, MD, MSc, assistant professor of medicine and director of hospital medicine research at the University of Utah School of Medicine, told Healio. “So, the question began to form in our minds: are stewardship recommendations made by men and women pharmacists followed differently?”
Vaughn and colleagues assessed gender-related differences in pharmacists-led antibiotic timeouts for patients on antibiotics before discharge in a study conducted from May to October 2019.
During the study period, pharmacists at the hospital conducted 295 timeouts, with more than half (54%) being conducted by 12 female pharmacists and the rest (46%) by eight male pharmacists.
Vaughn and colleagues found that 29% of timeouts resulted in a pharmacist recommending an antibiotic change, with male pharmacists more likely to recommend a change (38% vs. 19%, P < .001).
When the changes were recommended, a higher proportion of recommendations made by men were accepted compared with those made by women (79% vs. 33%; P < .001), the researchers reported.
After adjusting for patient characteristics, the researchers deduced that pharmacist gender was significantly associated with whether antibiotic changes were recommended (adjusted OR = 0.35; 95% CI, 0.2-0.63, women vs. men) or accepted (aOR = 0.15; 95% CI, 0.07-0.33) during an antibiotic timeout.
“I think this has huge impact for how we think about antibiotic stewardship. Clinical pharmacists are often making stewardship recommendations — especially in small or rural hospitals where ID pharmacists are less available,” Vaughn said. “Women also make up the majority of clinical pharmacists. So, if women pharmacists are less likely to be listened to, this could really affect the ability to do stewardship and subsequent patient outcomes, not to mention the effect that constant rejection could have on burnout and satisfaction among pharmacists.”
She added, “In summary, gender bias could have a profound impact on clinical care and we need to figure out how to move the bar and reduce bias in these situations.”
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Vaughn V, et al. Abstract 131. Presented at: Society for Healthcare Epidemiology of America Spring Meeting; April 12-14, 2022 (hybrid meeting).
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