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Problems related to antifungal prescription: a qualitative study of the views of intensivists

Tânia Pereira Salci1, Adelia P Batilana, Ricardo Pietrobon

  • 1Post Graduate Program in Biosciences Applied to Pharmacy, Universidade Estadual de Maringá, Maringá, Paraná, Brazil.

Journal of Evaluation in Clinical Practice
|May 21, 2014
PubMed
Abstract

Insights

Intensivists face challenges prescribing antifungal medications due to complex factors. Implementing multidisciplinary support and local protocols can improve antifungal prescription practices in the intensive care unit (ICU).

Area of Science:

  • Medical Science
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Antifungal medication choice is critical for treatment success.
  • Existing guidelines exist, but qualitative data on antifungal prescribing challenges, especially in ICUs, is lacking.
  • Understanding intensivists' perspectives on antifungal use is crucial.

Purpose of the Study:

  • To qualitatively explore how intensivists approach antifungal prescribing in an adult intensive care unit (ICU).
  • To identify barriers and facilitators influencing antifungal medication use in critical care settings.

Main Methods:

  • Grounded Theory analytical method was employed for data analysis.
  • Individual, semi-structured interviews were conducted with physicians prescribing antifungals in an adult ICU.
  • Interviews included core and follow-up questions to gather in-depth insights.

Main Results:

  • Eight major themes emerged, grouped into three categories, highlighting interconnected reasons for non-conformity in antifungal prescribing.
  • A perceived negative cycle exists between prescription issues and knowledge seeking.
  • Resolving individual actions, enhancing multidisciplinary team integration, and implementing local protocols based on epidemiology can overcome prescription barriers.

Conclusions:

  • Prescription assistance, supported by a well-trained and consensus-driven multidisciplinary team, is essential.
  • The development and implementation of well-designed, localized protocols are vital for optimizing antifungal prescribing in ICUs.
Keywords:
antifungalbarriers to prescriptionintensive care unitintensivist opinionqualitative researchquality of health care

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