背景:抗菌素耐药性(AMR)是由不适当的抗生素使用驱动的紧迫的全球健康问题,反过来又受到各种社会的影响,系统性,和个人因素。这项研究,嵌套在FIND在尼泊尔的AMR诊断使用加速器临床试验中,旨在(I)探索患者的观点,看护者,和医护人员(HCWs)对抗生素处方依从性的影响,以及(ii)评估培训和沟通(T&C)干预对抗生素处方依从性的影响。
方法:使用定性,半结构化面试,干预前和第7天随访组件,和行为变化轮过程,我们调查了使用和滥用抗生素处方的促进因素和障碍.
结果:研究结果表明,抗生素处方的依从性受多种因素的复杂相互作用的影响,包括知识和理解,健忘,有效沟通,期望,信仰和习惯,态度和行为,方便购买,对医疗效果的信任,和孩子偏好的问题。T&C一揽子计划也被证明在解决治疗依从性的具体障碍方面发挥作用。
结论:总体而言,这项研究的结果提供了与抗生素使用相关的挑战的细致入微的理解,并建议量身定制的干预措施,由行为框架通知,可以提高处方依从性,可能适用于不同的环境,并有助于全球努力减轻AMR不断上升的威胁。
BACKGROUND: Antimicrobial resistance (AMR) is a pressing global health concern driven by inappropriate antibiotic use, which is in turn influenced by various social, systemic, and individual factors. This study, nested within FIND\'s AMR Diagnostic Use Accelerator clinical trial in Nepal, aimed to (i) explore the perspectives of patients, caregivers, and healthcare workers (HCWs) on antibiotic prescription adherence and (ii) assess the impact of a training and communication (T&C) intervention on adherence to antibiotic prescriptions.
METHODS: Using qualitative, semi-structured interviews, pre-intervention and Day 7 follow-up components, and the Behaviour Change Wheel process, we investigated the facilitators of and barriers to the use and misuse of antibiotic prescriptions.
RESULTS: Results of the study revealed that adherence to antibiotic prescriptions is influenced by a complex interplay of factors, including knowledge and understanding, forgetfulness, effective communication, expectations, beliefs and habits, attitudes and behaviours, convenience of purchasing, trust in medical effectiveness, and issues of child preferences. The T&C package was also shown to play a role in addressing specific barriers to treatment adherence.
CONCLUSIONS: Overall, the results of this study provide a nuanced understanding of the challenges associated with antibiotic use and suggest that tailored interventions, informed by behaviour frameworks, can enhance prescription adherence, may be applicable in diverse settings and can contribute to the global effort to mitigate the rising threat of AMR.