PDF(Pubmed)
Abstract：
BACKGROUND: Despite being a global public health concern, there is a research gap in analyzing implementation strategies for managing off-label drug use in children. This study aims to understand professional health managers\' perspectives on implementing the Guideline in hospitals and determine the Guideline\'s implementation facilitators and barriers.
METHODS: Pediatric directors, pharmacy directors, and medical department directors from secondary and tertiary hospitals across the country were recruited for online interviews. The interviews were performed between June 27 and August 25, 2022. The Consolidated Framework for Implementation Research (CFIR) was adopted for data collection, data analysis, and findings interpretation to implement interventions across healthcare settings.
RESULTS: Individual interviews were conducted with 28 healthcare professionals from all over the Chinese mainland. Key stakeholders in implementing the Guideline for the Management of Pediatric Off-Label Use of Drugs in China (2021) were interviewed to identify 57 influencing factors, including 27 facilitators, 29 barriers, and one neutral factor, based on the CFIR framework. The study revealed the complexity of the factors influencing managing children\'s off-label medication use. A lack of policy incentives was the key obstacle in external settings. The communication barrier between pharmacists and physicians was the most critical internal barrier.
CONCLUSIONS: To our knowledge, this study significantly reduces the implementation gap in managing children\'s off-label drug use. We provided a reference for the standardized management of children\'s off-label use of drugs.
METHODS: Pediatric directors, pharmacy directors, and medical department directors from secondary and tertiary hospitals across the country were recruited for online interviews. The interviews were performed between June 27 and August 25, 2022. The Consolidated Framework for Implementation Research (CFIR) was adopted for data collection, data analysis, and findings interpretation to implement interventions across healthcare settings.
RESULTS: Individual interviews were conducted with 28 healthcare professionals from all over the Chinese mainland. Key stakeholders in implementing the Guideline for the Management of Pediatric Off-Label Use of Drugs in China (2021) were interviewed to identify 57 influencing factors, including 27 facilitators, 29 barriers, and one neutral factor, based on the CFIR framework. The study revealed the complexity of the factors influencing managing children\'s off-label medication use. A lack of policy incentives was the key obstacle in external settings. The communication barrier between pharmacists and physicians was the most critical internal barrier.
CONCLUSIONS: To our knowledge, this study significantly reduces the implementation gap in managing children\'s off-label drug use. We provided a reference for the standardized management of children\'s off-label use of drugs.
摘要：
背景：尽管是全球公共卫生问题，在分析儿童超说明书用药管理的实施策略方面存在研究空白.本研究旨在了解专业健康管理者对医院实施指南的看法，并确定指南的实施促进者和障碍。
方法：儿科主任，药房主任,并招募了全国二级和三级医院的医疗部门主任进行在线面试。采访时间为2022年6月27日至8月25日。数据收集采用了实施研究综合框架(CFIR)，数据分析,和调查结果解释，以实施跨医疗机构的干预措施。
结果：对来自中国大陆的28名医疗保健专业人员进行了个人访谈。实施《中国儿科非药品标签使用管理指南（2021年）》的主要利益相关者进行了访谈，以确定57个影响因素，包括27名主持人，29个障碍，和一个中性因素，基于CFIR框架。该研究揭示了影响儿童超说明书用药管理因素的复杂性。缺乏政策激励是外部环境中的主要障碍。药剂师和医生之间的沟通障碍是最关键的内部障碍。
结论：据我们所知，这项研究显著缩小了儿童超说明书用药管理的实施差距.为儿童超说明书用药的规范化管理提供参考。
方法：儿科主任，药房主任,并招募了全国二级和三级医院的医疗部门主任进行在线面试。采访时间为2022年6月27日至8月25日。数据收集采用了实施研究综合框架(CFIR)，数据分析,和调查结果解释，以实施跨医疗机构的干预措施。
结果：对来自中国大陆的28名医疗保健专业人员进行了个人访谈。实施《中国儿科非药品标签使用管理指南（2021年）》的主要利益相关者进行了访谈，以确定57个影响因素，包括27名主持人，29个障碍，和一个中性因素，基于CFIR框架。该研究揭示了影响儿童超说明书用药管理因素的复杂性。缺乏政策激励是外部环境中的主要障碍。药剂师和医生之间的沟通障碍是最关键的内部障碍。
结论：据我们所知，这项研究显著缩小了儿童超说明书用药管理的实施差距.为儿童超说明书用药的规范化管理提供参考。
