PDF(Pubmed)
Abstract：
UNASSIGNED: Suboptimal doctor-patient communication drives inappropriate prescribing of antibiotics. We evaluated a communication intervention for general practitioners (GPs) in multicultural Dutch cities to improve antibiotic prescribing for respiratory tract infections (RTI).
UNASSIGNED: This was a non-randomized controlled before-after study. The study period was pre-intervention November 2019 – April 2020 and post-intervention November 2021 – April 2022. The intervention consisted of a live training (organized between September and November 2021), an E-learning, and patient material on antibiotics and antibiotic resistance in multiple languages. The primary outcome was the absolute number of prescribed antibiotic courses indicated for RTIs per GP; the secondary outcome was all prescribed antibiotics per GP. We compared the post-intervention differences in the mean number of prescribed antibiotics between the intervention (N = 25) and the control group (N = 110) by using an analysis of covariance (ANCOVA) test, while adjusting for the pre-intervention number of prescribed antibiotics. Additionally, intervention GPs rated the training and their knowledge and skills before the intervention and 3 months thereafter.
UNASSIGNED: There was no statistically significant difference in the mean number of prescribed antibiotics for RTI between the intervention and the control group, nor for mean number of overall prescribed antibiotics. The intervention GPs rated the usefulness of the training for daily practice a 7.3 (on a scale from 1–10) and there was a statistically significant difference between pre- and post-intervention on four out of nine items related to knowledge and skills.
UNASSIGNED: There was no change in GPs prescription behavior between the intervention and control group. However, GPs found the intervention useful and showed some improvement on self-rated knowledge and communication skills.
UNASSIGNED: This was a non-randomized controlled before-after study. The study period was pre-intervention November 2019 – April 2020 and post-intervention November 2021 – April 2022. The intervention consisted of a live training (organized between September and November 2021), an E-learning, and patient material on antibiotics and antibiotic resistance in multiple languages. The primary outcome was the absolute number of prescribed antibiotic courses indicated for RTIs per GP; the secondary outcome was all prescribed antibiotics per GP. We compared the post-intervention differences in the mean number of prescribed antibiotics between the intervention (N = 25) and the control group (N = 110) by using an analysis of covariance (ANCOVA) test, while adjusting for the pre-intervention number of prescribed antibiotics. Additionally, intervention GPs rated the training and their knowledge and skills before the intervention and 3 months thereafter.
UNASSIGNED: There was no statistically significant difference in the mean number of prescribed antibiotics for RTI between the intervention and the control group, nor for mean number of overall prescribed antibiotics. The intervention GPs rated the usefulness of the training for daily practice a 7.3 (on a scale from 1–10) and there was a statistically significant difference between pre- and post-intervention on four out of nine items related to knowledge and skills.
UNASSIGNED: There was no change in GPs prescription behavior between the intervention and control group. However, GPs found the intervention useful and showed some improvement on self-rated knowledge and communication skills.
摘要：
医患沟通欠佳导致抗生素处方不当。我们评估了荷兰多元文化城市中全科医生（GP）的沟通干预措施，以改善呼吸道感染（RTI）的抗生素处方。
■这是一项非随机对照前后研究。研究期间为2019年11月至2020年4月干预前和2021年11月至2022年4月干预后。干预包括现场培训(组织于2021年9月至11月)，电子学习，以及用多种语言编写的关于抗生素和抗生素耐药性的患者材料。主要结果是每个GP的RTIs指定的处方抗生素疗程的绝对数量；次要结果是每个GP的所有处方抗生素。我们通过使用协方差分析（ANCOVA）检验，比较了干预组（N=25）和对照组（N=110）之间处方抗生素平均数量的干预后差异，同时调整处方抗生素的干预前数量。此外,干预全科医生在干预前和干预后3个月对培训及其知识和技能进行了评估.
■干预组和对照组之间的RTI处方抗生素的平均数量没有统计学上的显着差异，总体处方抗生素的平均数量也是如此。干预全科医生对日常实践培训的有用性评分为7.3（1-10分），并且在与知识和技能相关的9个项目中，有4个在干预前和干预后之间存在统计学上的显着差异。
■干预组和对照组之间的全科医生处方行为没有变化。然而,全科医生发现干预是有用的，并且在自我评估的知识和沟通技巧方面表现出一定的改善。
■这是一项非随机对照前后研究。研究期间为2019年11月至2020年4月干预前和2021年11月至2022年4月干预后。干预包括现场培训(组织于2021年9月至11月)，电子学习，以及用多种语言编写的关于抗生素和抗生素耐药性的患者材料。主要结果是每个GP的RTIs指定的处方抗生素疗程的绝对数量；次要结果是每个GP的所有处方抗生素。我们通过使用协方差分析（ANCOVA）检验，比较了干预组（N=25）和对照组（N=110）之间处方抗生素平均数量的干预后差异，同时调整处方抗生素的干预前数量。此外,干预全科医生在干预前和干预后3个月对培训及其知识和技能进行了评估.
■干预组和对照组之间的RTI处方抗生素的平均数量没有统计学上的显着差异，总体处方抗生素的平均数量也是如此。干预全科医生对日常实践培训的有用性评分为7.3（1-10分），并且在与知识和技能相关的9个项目中，有4个在干预前和干预后之间存在统计学上的显着差异。
■干预组和对照组之间的全科医生处方行为没有变化。然而,全科医生发现干预是有用的，并且在自我评估的知识和沟通技巧方面表现出一定的改善。
