Abstract:
Governments and healthcare organisations collect data on antibiotic prescribing (AP) for surveillance. This data can support tools for visualisations and feedback to GPs using dashboards that may prompt a change in prescribing behaviour. The objective of this systematic review was to assess the effectiveness of interactive dashboards to optimise AP in primary care. Six electronic databases were searched for relevant studies up to August 2022. A narrative synthesis of findings was conducted to evaluate the intervention processes and results. Two independent reviewers assessed the relevance, risk of bias and quality of the evidence. A total of ten studies were included (eight RCTs and two non-RCTs). Overall, seven studies showed a slight reduction in AP. However, this reduction in AP when offering a dashboard may not in itself result in reductions but only when combined with educational components, public commitment or behavioural strategies. Only one study recorded dashboard engagement and showed a difference of 10% (95% CI 5% to 15%) between intervention and control. None of the studies reported on the development, pilot or implementation of dashboards or the involvement of stakeholders in design and testing. Interactive dashboards may reduce AP in primary care but most likely only when combined with other educational or behavioural intervention strategies.
摘要:
政府和医疗机构收集抗生素处方(AP)的数据进行监测。这些数据可以支持使用仪表板对GP进行可视化和反馈的工具,这些仪表板可能会提示处方行为的变化。本系统评价的目的是评估交互式仪表板在初级保健中优化AP的有效性。截至2022年8月,已搜索了六个电子数据库进行相关研究。对结果进行了叙述性综合,以评估干预过程和结果。两名独立审稿人评估了相关性,偏倚风险和证据质量。共纳入10项研究(8项RCT和2项非RCT)。总的来说,七项研究显示AP略有减少。然而,提供仪表板时AP的这种减少本身可能不会导致减少,而只有与教育组件结合使用时,公共承诺或行为策略。只有一项研究记录了仪表板参与度,并显示干预和控制之间存在10%的差异(95%CI5%至15%)。没有一项研究报道了这种发展,仪表板的试点或实施或利益相关者参与设计和测试。交互式仪表板可能会减少初级保健中的AP,但最有可能仅与其他教育或行为干预策略结合使用。