影响医生的抗菌素处方决定的因素:对定性研究的系统审查
Savannah Reali1,2,3,4, Yee Chin Kwang5, Jin-Gun Cho6,7
1School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia.
医生在决定抗微生物药物处方时面临许多因素,平衡患者需求与更广泛的抗微生物药物耐药性问题. 了解这些影响是改善处方实践和打击耐药性的关键.
科学领域:
- 医学科学 医学科学 医学科学
- 公共卫生 公共卫生
- 药理学 药理学是指药理学的学科.
背景情况:
- 不适当的抗微生物药物使用助长了抗微生物药物耐药性,这是一个重大的全球健康威胁.
- 优化抗微生物药物处方需要对医生决策过程有深刻的了解.
研究的目的:
- 系统地审查和识别影响医生的抗菌素处方决定的因素.
- 开发一个模型,说明抗微生物药物处方的复杂性.
主要方法:
- 从2014年开始进行系统的文献搜索 (Embase,Medline,Scopus).
- 包括具有直接医生数据的定性研究,遵守PRISMA指南.
- 将影响因素提取和分类为医生,患者,药物/病情和外部领域.
主要成果:
- 来自23个国家的53项研究确定了40个影响因素.
- 关键因素包括时间压力,患者需求,诊断不确定性,临床经验以及指导方针/诊断工具的使用.
- 医生经常认为,对个体患者处方不足的风险大于过度处方引起的抗菌素耐药性的人口风险.
结论:
- 处方抗菌剂是一个复杂的决定,在整个过程中受到多方面的因素的影响.
- 对这些决定因素的认识对于设计有效的干预措施来优化抗菌素使用至关重要.
- 未来的干预措施必须平衡个体患者的需求与人口层面的抗菌药物管理目标.
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