A pharmacist-led, workplace-based educational intervention informed by behavioral science to influence antimicrobial prescribing in Japan

Abstract

PURPOSE: Changing antimicrobial prescribing behavior is a key challenge in antimicrobial stewardship (AMS). In postgraduate clinical education, knowledge-based teaching alone is often insufficient to achieve sustained behavior change, highlighting the need for workplace-based educational designs informed by behavioral science. METHODS: We conducted a retrospective before-after study to evaluate a pharmacist-led educational intervention designed to influence prescribing behavior of piperacillin/tazobactam (TZP) in Japan. The educational component, consisting of a pharmacist-developed video and post-test, was completed once by physicians prior to implementation, whereas a structured prescription rationale requirement was applied at each TZP prescribing event. Prescribing behavior was assessed using days of therapy (DOT) and antibiotic use density (AUD) over 6 months before and after the intervention. Educational components were treated as process indicators of engagement rather than primary outcomes. RESULTS: All full-time physicians completed the instructional video and the post-test. Following the intervention, TZP use decreased by 22.3% in DOT, with consistent reductions observed in season-matched comparisons. Similar trends were observed for AUD. CONCLUSION: Workflow-embedded reflective prompts may be useful as a workplace-based educational strategy for influencing antimicrobial prescribing behavior.