目标:了解初级保健医生对抗菌药物管理团队学术细节的看法,以对抗COVID-19时代上呼吸道感染和支气管炎的抗生素过度使用,这将有助于防止可避免的门诊就诊。
方法:在这项前瞻性研究中,14名克罗地亚女医生使用半结构化指南完成了标准化的定性访谈。数据采用基于反身主题分析的归纳法进行分析。我们使用了一种基于医疗干预实施性概念框架的理论方法,该框架侧重于三个领域:可接受性,保真度,和可行性。
结果:我们确定了六个关键主题,突出了改变处方实践的障碍,患者的压力和专家的建议对学术细节的有效性有影响。尽管面临挑战,初级保健医生描述了与循证实践的直接互动的赞赏和报告的有用性,有效性,并进一步需要学术细节。
结论:本研究强调了实施医疗保健干预措施所涉及的复杂动态,并为加强旨在改善抗生素处方实践的策略提供了有价值的见解。具体来说,我们的研究结果强调了影响医师抗生素处方行为变化的因素.作者主张采用社区和医院专业人员的协作方法,以提供量身定制的指导并解决问题。最终改善处方实践。
OBJECTIVE: To understand primary care physicians\' perspectives on academic detailing from an antimicrobial stewardship team to combat antibiotic overuse for upper respiratory infections and bronchitis in the COVID-19 era, which will help prevent avoidable outpatient visits.
METHODS: In this prospective study, 14 female Croatian physicians completed standardized qualitative interviews using a semi-structured guide. The data were analyzed using inductive methodology based on reflexive thematic analysis. We used a theoretically informed approach based on a conceptual framework of healthcare intervention implementability focused on three domains: acceptability, fidelity, and feasibility.
RESULTS: We identified six key themes highlighting barriers to changing prescribing practices, with patient pressure and specialist recommendations having an impact on the effectiveness of academic detailing. Despite challenges, primary care physicians described appreciation of direct interaction with evidence-based practices and reported usefulness, effectiveness, and further need for academic detailing.
CONCLUSIONS: This study highlights the complex dynamics involved in implementing healthcare interventions and provides valuable insights for enhancing strategies directed at improving antibiotic prescribing practices. Specifically, our findings emphasize factors influencing behavior changes in physicians\' antibiotic prescribing. The authors advocate for a collaborative approach involving community and hospital-based professionals to provide tailored guidance and address questions, ultimately improving prescribing practices.