Effectiveness of Antimicrobial Stewardship Training on Pharmacists’ Competence and Hospital ASP Implementation : A Multidisciplinary Approach in Riau Islands Province, Indonesia

Background Antimicrobial resistance (AMR) is a global health threat requiring effective control through Antimicrobial Stewardship Programs (ASP). Pharmacists play a key role in ensuring rational antibiotic use, yet the effectiveness of ASP depends on institutional support and multidisciplinary collaboration. Objective This study aimed to evaluate the effect of training on hospital pharmacists’ competence and its correlation with ASP implementation at the hospital level. Methods A quasi-experimental pre–post intervention design without a control group was conducted among 103 pharmacists from 29 hospitals in Riau Islands Province between August 2024 and January 2025. Data were analyzed using Wilcoxon, McNemar, and Spearman correlation tests. Results Pharmacists’ competence significantly improved after the training (Z = -8.825, p < 0.001), with 94.2% showing improvement in competence category. However, no significant correlation was found between pharmacists’ competence improvement and hospital ASP performance (r = 0.046; p = 0.813). These findings indicate that ASP effectiveness depends not only on pharmacists’ capacity but also on hospital structural support, the role of attending physicians, and collaboration among other healthcare professionals. Conclusion ASP training effectively enhances pharmacists’ competence but is insufficient to drive systemic improvement in antimicrobial resistance control. Successful AMS implementation requires a multidisciplinary approach, managerial policy support, and strengthened human resource capacity and microbiology laboratory infrastructure within hospitals.