患者,医生和访问特征与日本初级保健中不适当的抗生素处方的关联:一个横截面研究
Atsushi Miyawaki1,2,3, Joseph B Ladines-Lim4,5, Daichi Sato6
1Public Health Research Group, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
BMJ public health
|August 22, 2025
概括
在这项研究中,发现日本初级保健中不适当的抗生素处方率为17. 0%. 年轻患者,老年医生和远程医疗等因素与不适当的抗生素使用增加有关.
科学领域:
- 主要护理研究
- 抗菌药物管理
- 医疗服务研究
背景情况:
- 抗生素耐药性是一个全球性的健康威胁,
- 了解日本的处方模式对于制定有针对性的干预措施至关重要.
研究的目的:
- 确定日本初级保健中不适当的抗生素处方的普遍性.
- 确定与不适当的抗生素处方相关的患者,医生和访问相关因素.
主要方法:
- 一项横截面研究分析了来自日本初级保健诊所的200多万份抗生素处方 (2022年10月至2023年9月).
- 一个分类算法根据诊断代码对处方进行了适当,潜在的适当或不适当的分类.
- 一个线性概率模型确定了与个人实践诊所不适当处方相关的因素.
主要成果:
- 17. 0% 的抗生素处方被归类为不合适.
- 在较年轻的患者 (< 18 岁) 和患有并发症 (查尔森并发症指数 ≥ 2) 的患者中,不适当的处方更为常见.
- 年长的医生 (≥65岁),大量处方的医生,远程医疗访问和定期的护理时间也与不适当的处方有关.
结论:
- 需要针对特定的患者群体 (年轻人,共患病),医生特征 (年龄,处方量) 和访问类型 (远程医疗,定期时间) 的有针对性的干预措施.
- 改善日本初级保健中的抗菌管理需要解决这些已识别的风险因素.
- 这些发现凸显了对抗生素处方实践的持续监测和质量改进举措的需要.
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