PDF(Pubmed)
Abstract：
UNASSIGNED: Antimicrobial resistance (AMR) is a major public health threat. With the growing emphasis on patient-centred care/ shared decision making, it is important for healthcare professionals\' (HCPs) who prescribe, dispense, administer and/or monitor antimicrobials to be adequately equipped to facilitate appropriate antimicrobial use. We systematically identified existing interventions which aim to improve HCPs interaction with patients and examined barriers and facilitators of appropriate the use of such interventions and appropriate antimicrobial use among both HCPs and patientsantimicrobial use while using these interventions.
UNASSIGNED: We searched MEDLINE, EMBASE, Web of Science, Google Scholar, and internet (via Google search engine). We included primary studies, published in English from 2010 to 2023 [PROSPERO (CRD42023395642)]. The protocol was preregistered with PROSPERO (CRD42023395642). We performed quality assessment using mixed methods appraisal tool. We applied narrative synthesis and used the COM-B (Capability, Opportunity, Motivation -Behaviour) as a theoretical framework for barriers and facilitators at HCP and patient levels.
UNASSIGNED: Of 9,172 citations retrieved from database searches, From 4,979 citations remained after removal of duplicates. We included 59 studies spanning over 13 countries. Interventions often involved multiple components beyond HCPs\' interaction with patients. From 24 studies reporting barriers and facilitators, we identified issues relating to capability (such as, knowledge/understanding about AMR, diagnostic uncertainties, awareness of interventions and forgetfulness); opportunity (such as, time constraint and intervention accessibility) and motivation (such as, patient\'s desire for antibiotics and fear of litigation).
UNASSIGNED: The findings of this review should be considered by intervention designers/adopters and policy makers to improve utilisation and effectiveness.
UNASSIGNED: We searched MEDLINE, EMBASE, Web of Science, Google Scholar, and internet (via Google search engine). We included primary studies, published in English from 2010 to 2023 [PROSPERO (CRD42023395642)]. The protocol was preregistered with PROSPERO (CRD42023395642). We performed quality assessment using mixed methods appraisal tool. We applied narrative synthesis and used the COM-B (Capability, Opportunity, Motivation -Behaviour) as a theoretical framework for barriers and facilitators at HCP and patient levels.
UNASSIGNED: Of 9,172 citations retrieved from database searches, From 4,979 citations remained after removal of duplicates. We included 59 studies spanning over 13 countries. Interventions often involved multiple components beyond HCPs\' interaction with patients. From 24 studies reporting barriers and facilitators, we identified issues relating to capability (such as, knowledge/understanding about AMR, diagnostic uncertainties, awareness of interventions and forgetfulness); opportunity (such as, time constraint and intervention accessibility) and motivation (such as, patient\'s desire for antibiotics and fear of litigation).
UNASSIGNED: The findings of this review should be considered by intervention designers/adopters and policy makers to improve utilisation and effectiveness.
摘要：
■抗菌素耐药性（AMR）是主要的公共卫生威胁。随着人们越来越重视以患者为中心的护理/共享决策，这对开处方的医疗保健专业人员(HCP)来说很重要，分配,施用和/或监测抗微生物剂，以充分配备，以促进适当的抗微生物剂使用。我们系统地确定了旨在改善HCPs与患者互动的现有干预措施，并检查了适当使用此类干预措施以及在使用这些干预措施时在HCPs和患者抗菌药物使用中适当使用抗菌药物的障碍和促进因素。
■我们搜索了MEDLINE,EMBASE,WebofScience,谷歌学者，和互联网（通过谷歌搜索引擎）。我们纳入了主要研究，2010年至2023年以英文出版[PROSPERO(CRD42023395642)]。该方案在PROSPERO(CRD42023395642)中预先注册。我们使用混合方法评估工具进行质量评估。我们应用了叙事综合，并使用了COM-B(能力，机会,动机-行为)作为HCP和患者水平的障碍和促进者的理论框架。
■在从数据库搜索中检索到的9,172条引文中，从4,979个引文删除重复后仍然存在。我们纳入了超过13个国家的59项研究。干预通常涉及HCP与患者相互作用之外的多种成分。从24项报告障碍和促进者的研究中，我们确定了与能力相关的问题(例如，关于AMR的知识/理解，诊断不确定性，对干预和健忘的意识)；机会(例如，时间约束和干预可及性)和动机(例如，患者对抗生素的渴望和对诉讼的恐惧)。
■干预设计者/采用者和政策制定者应考虑本审查的结果，以提高利用率和有效性。
■我们搜索了MEDLINE,EMBASE,WebofScience,谷歌学者，和互联网（通过谷歌搜索引擎）。我们纳入了主要研究，2010年至2023年以英文出版[PROSPERO(CRD42023395642)]。该方案在PROSPERO(CRD42023395642)中预先注册。我们使用混合方法评估工具进行质量评估。我们应用了叙事综合，并使用了COM-B(能力，机会,动机-行为)作为HCP和患者水平的障碍和促进者的理论框架。
■在从数据库搜索中检索到的9,172条引文中，从4,979个引文删除重复后仍然存在。我们纳入了超过13个国家的59项研究。干预通常涉及HCP与患者相互作用之外的多种成分。从24项报告障碍和促进者的研究中，我们确定了与能力相关的问题(例如，关于AMR的知识/理解，诊断不确定性，对干预和健忘的意识)；机会(例如，时间约束和干预可及性)和动机(例如，患者对抗生素的渴望和对诉讼的恐惧)。
■干预设计者/采用者和政策制定者应考虑本审查的结果，以提高利用率和有效性。
