Department of Medicine, University of California, San Francisco, CA, USA.
Patient Educ Couns. 2011 Dec;85(3):493-8. doi: 10.1016/j.pec.2011.02.005. Epub 2011 Mar 9.
Over-use of antibiotics for acute respiratory infections (ARIs) increases antimicrobial resistance, treatment costs, and side effects. Patient desire for antibiotics contributes to over-use.
To explore whether a point-of-care interactive computerized education module increases patient knowledge and decreases desire for antibiotics.
Bilingual (English/Spanish) interactive kiosks were available in 8 emergency departments as part of a multidimensional intervention to reduce antibiotic prescribing for ARIs. The symptom-tailored module included assessment of symptoms, knowledge about ARIs (3 items), and desire for antibiotics on a 10-point visual analog scale. Multivariable analysis assessed predictors of change in desire for antibiotics.
Of 686 adults with ARI symptoms, 63% initially thought antibiotics might help. The proportion of patients with low (1-3 on the scale) desire for antibiotics increased from 22% pre-module to 49% post-module (p<.001). Self-report of "learning something new" was associated with decreased desire for antibiotics, after adjusting for baseline characteristics (p=.001).
An interactive educational kiosk improved knowledge about antibiotics and ARIs. Learning correlated with changes in personal desire for antibiotics.
By reducing desire for antibiotics, point-of-care interactive educational computer technology may help decrease inappropriate use for antibiotics for ARIs.
过度使用抗生素治疗急性呼吸道感染会增加抗药性、治疗费用和副作用。患者对抗生素的需求也是导致过度使用的原因之一。
探究即时互动计算机教育模块是否能提高患者的知识水平并降低他们对抗生素的需求。
作为减少急性呼吸道感染抗生素处方多维干预的一部分，8 家急诊室配备了双语（英语/西班牙语）互动亭。症状定制模块包括症状评估、对急性呼吸道感染的认识（3 项）以及对 10 分制视觉模拟量表上的抗生素需求。多变量分析评估了抗生素需求变化的预测因素。
686 名有急性呼吸道感染症状的成年人中，63%的人最初认为抗生素可能有帮助。低（1-3 分）抗生素需求的患者比例从模块前的 22%增加到模块后的 49%（p<.001）。调整基线特征后，自我报告“学到了新知识”与降低对抗生素的需求相关（p=.001）。
互动式教育亭提高了患者对抗生素和急性呼吸道感染的认识。学习与个人对抗生素需求的变化相关。
通过降低对抗生素的需求，即时互动教育计算机技术可能有助于减少急性呼吸道感染中对抗生素的不当使用。
