•It was identified in this systematic review that interventions of an anticoagulation stewardship programme (ASP) have an overall improvement in anticoagulation use.•The core elements of ASP should be considered and incorporated into the activities of a hospital ASP to ensure the coordinated, efficient and sustained system-level approach to anticoagulant safety and use.•The success of antimicrobial stewardship programmes should serve as a model for ASP to support its implementation within hospitals and to embed it as an essential component of patient safety within the hospital setting.

Abstract Introduction There has been a significant increase in the number of patients prescribed Direct Oral Anticoagulants (DOACs) (1). One of the advantages of DOACs is reduced need for monitoring compared to warfarin, however less frequent contact with healthcare professionals (HCPs) may contribute to poor patient knowledge leading to negative health consequences. Aim To determine patients’ knowledge on DOACs in the hospital and community pharmacy setting. Methods Participants were recruited from a university hospital and from a convenience sample of community pharmacies. Potential participants were identified by the pharmacist in that setting using the following criteria: age ≥18 years, adequate cognition, DOAC use ≥3 months. Following consent, the participant completed a questionnaire which consisted of participant demographics and questions from the KODOA (The Knowledge of Direct Oral Anticoagulants) questionnaire. Depending on participant preference, they either self-completed the questionnaire or provided oral answers which the researcher documented. Based on previous research (2), a target sample of 40 participants was set. Descriptive statistics were performed. Results 40 participants were recruited; the mean (SD) age was 70.2 years (10.1), with 70% of participants reporting male gender. 62.5% of participants had an indication of atrial fibrillation. Mean (SD) duration of DOAC use was 5.6 years (3.6). Most patients rated their knowledge of their DOAC as moderate (50%) or good (27.5%). The results of the KODOA are presented in the table. The average score achieved by participant was 11.55/15 (± 1.88 SD). Participants scored high in areas such as DOAC indication, frequency of dosing, side-effects, drug interactions and when to seek further help. Areas of knowledge deficits included what to do when patients have forgotten a dose or have taken too much DOAC. Conclusion One limitation of the questionnaire is that the questions are presented in a multiple-choice format and it is possible that participants may have selected the correct answer due to chance. However, overall, participants demonstrated good levels of knowledge of their DOAC therapy. This study has identified areas of knowledge deficits which could be included in patient education when HCPs are counselling patients, when starting their DOAC and continually throughout treatment. References (1) Barry, Michael. Medicines Management Programme: Oral anticoagulants for stroke prevention in non-valvular atrial fibrillation [Internet]. 2019 [cited 2021 Jul 24]. Available from: https://www.hse.ie/eng/about/who/cspd/ncps/medicines-management/oral-anticoagulants/oral-anticoagulants-for-stroke-prevention-in-non-valvular-atrial-fibrillation-march-2019.pdf (2) Metaxas C, Albert V, Stahl M, Hersberger KE, Arnet I. Development and validation of a questionnaire to self-assess patient knowledge of direct oral anticoagulants (KODOA-test). Drug Healthc Patient Saf. 2018 Jul 20;10:69–77.

Abstract Background Antimicrobial stewardship (AMS) is essential to control the emergence of antimicrobial resistance (AMR) which has become an international health priority. Education of undergraduate students on AMS and AMR is a strategic objective in the WHO Global Action Plan on AMR and Ireland's National Action Plan.1,2 Research on AMS/AMR education has focused primarily on medical students with less emphasis on those from other healthcare profession including pharmacy students. Objectives To investigate AMS and AMR education in the Pharmacy undergraduate programme in the School of Pharmacy of an Irish University. Methods A mixed methods study was conducted. Ten semi-structured interviews were conducted in October 2019 with academic staff to capture their views on AMS education. Participants included staff members from different disciplines, those identified as involved in teaching elements of infectious disease, antibiotics, AMS and related topics, and those involved in curriculum design and approval within the School of Pharmacy. Interview transcripts were analysed by thematic analysis. An electronic survey of 17 questions was emailed to all second to fifth year UCC Pharmacy students in October 2019 to gather students’ views and experiences of AMS education. The survey contained four sections which addressed demographics, AMS, resources and education using open-ended, closed-ended or Likert-scale questions. Ethical approval was obtained. Results Six key themes were identified from the ten interviews: (i) curriculum priorities and capacity; (ii) housing of the subject, fragmentation and cohesion; (iii) integration; (iv) communication; (v) teaching methods; and (vi) assessment methods. 113 students participated in the survey (32.3% response rate). 96% agree that a strong knowledge of antimicrobials for their future careers is important, and over 89% of students desire more education on AMR and AMS. Only 43% of students found their AMS education provided sufficient preparation for practice. Students felt most prepared to recognize clinical signs of infection and least prepared for IV to oral switching, interpreting biological marker and de-escalation of antimicrobials. Over 50% of students never used or were not familiar with the national primary care antimicrobial guidelines: www.antibioticprescribing.ie. Conclusions Pharmacy students and staff agree that AMS and AMR are important and need enhanced educational focus. Students feel there are gaps in their AMS education and expressed a desire for more education in this area. Improved communication and identification of curriculum priorities by staff could help to establish a more cohesive and comprehensive educational approach to this area.