常规数据注册作为分析和提高初级保健中抗菌素处方质量的基础
Martijn Sijbom1, Mirte Boelens2, Mark G J de Boer3,4
1Department of Public Health and Primary Care / Health Campus The Hague, Leiden University Medical Centre, Turfmarkt 99, The Hague, Leiden, DP, 2511, The Netherlands. m.sijbom@lumc.nl.
BMC primary care
|October 17, 2025
概括
在初级保健中过度使用抗微生物药物会导致耐药性. 结合医疗保健和社会经济数据,揭示了患者因素和实践规模影响处方质量,特别是在呼吸道感染和宏类药物方面.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 医疗保健服务研究 医疗服务研究
背景情况:
- 抗微生物药物耐药性 (AMR) 是一个日益增长的威胁,主要是由抗微生物药物的过度使用驱动的.
- 初级保健机构占抗菌素处方的80-90%.
- 识别处方质量的新决定因素对于打击AMR至关重要.
研究的目的:
- 在初级保健中评估抗菌素处方质量.
- 确定不适当处方的社会经济和实践相关决定因素.
- 为了利用医疗保健和社会经济数据的结合,对AMR产生新的见解.
主要方法:
- 利用了来自269,547名患者和1,150,252份抗菌素处方 (2012-2020) 的伪名化数据.
- 将初级保健数据与国家社会经济数据联系起来.
- 对指导方针进行处方质量的分析,并使用后勤回归来确定决定因素.
主要成果:
- 呼吸道感染 (RTIs) 显示出不适当处方的最高率 (14.5%).
- 很大一部分 (77.1%) 的类药物处方不符合指导方针的建议.
- 患者因素 (移民背景,性别,并发症,年龄) 和较大的实践规模与较差的准则遵守有关.
结论:
- 整合社会经济和日常医疗保健数据为AMR提供了有价值的见解.
- 现在的RTIs和类药物处方是需要改进的关键领域,特别是在风险患者群体中.
- 提高护理和咨询时间的连续性可能对有效的抗抗药性干预策略至关重要.
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