快速C反应蛋白测试和沟通技巧培训对急性咳的抗生素处方的影响. 一个集群因子随机对照试验
Carl Llor1,2,3, Marta Trapero-Bertran4, Antoni Sisó-Almirall5
1University Institute in Primary Care Research Jordi Gol (IDIAPJGol), Barcelona, Spain. cllor@health.sdu.dk.
NPJ primary care respiratory medicine
|May 9, 2024
概括
增强的沟通技巧培训显著减少了成年人下呼吸道感染的抗生素消耗. 持续培训干预措施在降低抗生素处方率方面表现有希望.
科学领域:
- 主要护理是指初级护理.
- 传染性疾病 传染性疾病
- 临床试验 临床试验
背景情况:
- 对急性咳和下呼吸道感染 (LRTI) 过度使用抗生素有助于抗菌素耐药性.
- 需要有效的干预措施来优化初级保健机构的抗生素处方.
研究的目的:
- 评估C反应蛋白 (CRP) 快速测试和增强沟通技巧 (ECS) 培训对LRTI成年人抗生素消费的影响.
- 评估CRP测试和ECS培训与常规护理相比的组合和单独影响.
主要方法:
- 在20个初级保健中心进行集群随机临床试验.
- 干预措施包括CRP快速检测,ECS培训或组合,与通常护理相比.
- 主要结局是6周的抗生素消耗和质量调整寿命年.
主要成果:
- 与常规护理 (56.7%) 相比,ECS组的抗生素消耗明显较低 (33.9%).
- 单独的CRP测试并没有显著降低抗生素消耗 (43.8%).
- 综合干预显示了消费减少的趋势 (38.4%),尽管在统计学上并不显著.
结论:
- 持续增强沟通技能的培训可以有效地减少在初级保健中为LRTI的抗生素处方.
- 虽然单独CRP测试没有显著影响,但与ECS相结合,它需要进一步调查.
- 尽管由于COVID-19减少了样本大小的局限性,但该研究强调了在抗菌药物管理中培养沟通技能的价值.
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