多方面的抗微生物管理计划的长期影响,包括审计和反,对初级保健中的急性喉痛 - 一个随机对照试验
Stefan Malmberg1, Maria Hess-Wargbaner2, Denny Björk2
1General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Hälsobrunnen Primary Health Care Clinic, Ulricehamn, Sweden.
概括
六个月的抗生素管理计划 (ASP) 并没有改善初级保健中长期遵守喉痛指南. 需要进一步的研究,以找到有效的策略来改变抗生素处方行为.
科学领域:
- 一般的做法一般的做法
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 急性喉疼痛经常导致抗生素处方,医生对指南的遵守率低于最佳水平.
- 需要抗生素管理计划 (ASP) 来解决治疗喉疼痛的不确定性.
- 评估多方面的ASP对准则遵守的长期影响至关重要.
研究的目的:
- 评估多方面的抗生素管理计划 (ASP) 是否可以提高长期遵守喉疼痛管理指南.
- 调查在初级保健机构中全面的ASP的有效性.
主要方法:
- 在瑞典的初级保健中心进行了一项随机对照试验.
- 该干预涉及为期六个月的多方面的ASP,包括从业人员会议,案例讨论,质量改进举措和对处方数据的反.
- 测量的主要结果是对Streptococcus pyogenes阳性病例的抗生素处方的变化.
主要成果:
- 对于喉突炎病例,基线准则的遵守率约为三分之二.
- 在干预组或对照组中,在6个月,12个月或18个月后,没有观察到遵守指南的显著改善.
- 多方面的ASP没有导致处方行为的持续变化.
结论:
- 六个月的多方面ASP没有改善急性喉疼痛管理的长期准则遵守.
- 需要采取替代策略,以促进抗生素处方实践的可持续变化.
- 进一步的研究应该探索在初级保健中对抗生素管理的新方法.
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