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基于证据的抗菌药物管理智能手机应用程序在医院门诊中的应用:基于调查的患者需求评估。

An Evidence-Based Antimicrobial Stewardship Smartphone App for Hospital Outpatients: Survey-based Needs Assessment Among Patients.

机构信息

National Institute for Health Research (NIHR) Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College, London, United Kingdom.

出版信息

JMIR Mhealth Uhealth. 2016 Jul 6;4(3):e83. doi: 10.2196/mhealth.5243.


DOI:10.2196/mhealth.5243
PMID:27383743
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4954917/
Abstract

BACKGROUND: Current advances in modern technology have enabled the development and utilization of electronic medical software apps for both mobile and desktop computing devices. A range of apps on a large variety of clinical conditions for patients and the public are available, but very few target antimicrobials or infections. OBJECTIVE: We sought to explore the use of different antimicrobial information resources with a focus on electronic platforms, including apps for portable devices, by outpatients at two large, geographically distinct National Health Service (NHS) teaching hospital trusts in England. We wanted to determine whether there is demand for an evidence-based app for patients, to garner their perceptions around infections/antimicrobial prescribing, and to describe patients' experiences of their interactions with health care professionals in relation to this topic. METHODS: A cross-sectional survey design was used to investigate aspects of antimicrobial prescribing and electronic devices experienced by patients at four hospitals in London and a teaching hospital in the East of England. RESULTS: A total of 99 surveys were completed and analyzed. A total of 82% (80/98) of respondents had recently been prescribed antimicrobials; 87% (85/98) of respondents were prescribed an antimicrobial by a hospital doctor or through their general practitioner (GP) in primary care. Respondents wanted information on the etiology (42/65, 65%) and prevention and/or management (32/65, 49%) of their infections, with the infections reported being upper and lower respiratory tract, urinary tract, oral, and skin and soft tissue infections. All patients (92/92, 100%) desired specific information on the antimicrobial prescribed. Approximately half (52/95, 55%) stated it was "fine" for doctors to use a mobile phone/tablet computer during the consultation while 13% (12/95) did not support the idea of doctors accessing health care information in this way. Although only 30% (27/89) of respondents reported on the use of health care apps, 95% (81/85) offered information regarding aspects of antimicrobials or infections that could be provided through a tailored app for patients. Analysis of the comments revealed the following main global themes: knowledge, technology, and patient experience. CONCLUSIONS: The majority of respondents in our study wanted to have specific etiological and/or infection management advice. All required antimicrobial-related information. Also, most supported the use of electronic resources of information, including apps, by their doctors. While a minority of people currently use health apps, many feel that apps could be used to provide additional support/information related to infections and appropriate use of antimicrobials. In addition, we found that there is a need for health care professionals to engage with patients and help address common misconceptions around the generation of antimicrobial resistance.

摘要

背景:现代科技的进步使移动和桌面计算设备能够开发和利用电子医疗软件应用程序。针对患者和公众的大量各种临床情况的应用程序已经出现,但针对抗菌药物或感染的应用程序非常少。

目的:我们旨在探索使用不同的抗菌药物信息资源,重点是电子平台,包括便携式设备的应用程序,由英格兰两家大型、地理位置不同的国民保健服务(NHS)教学医院的门诊患者使用。我们想确定是否有针对患者的基于证据的应用程序的需求,以了解他们对感染/抗菌药物处方的看法,并描述患者在与该主题相关的医疗保健专业人员的互动方面的经验。

方法:采用横断面调查设计,调查伦敦四家医院和英格兰东部一所教学医院的患者的抗菌药物处方和电子设备方面的情况。

结果:共完成并分析了 99 份调查问卷。共有 82%(80/98)的受访者最近被开了抗菌药物;87%(85/98)的受访者是在医院医生或初级保健医生(GP)处开的抗菌药物。受访者希望获得关于他们感染的病因(42/65,65%)和预防和/或管理(32/65,49%)的信息,报告的感染包括上呼吸道、下呼吸道、尿路、口腔和皮肤软组织感染。所有患者(92/92,100%)都希望获得有关所开抗菌药物的具体信息。约有一半(52/95,55%)的患者表示医生在咨询期间使用手机/平板电脑“没问题”,而 13%(12/95)的患者不支持医生以这种方式获取医疗保健信息。尽管只有 30%(27/89)的受访者报告了使用医疗保健应用程序,但 95%(81/85)的受访者提供了与抗菌药物或感染相关的信息,这些信息可以通过为患者定制的应用程序提供。对评论的分析揭示了以下主要的全球主题:知识、技术和患者体验。

结论:我们研究中的大多数受访者希望获得具体的病因和/或感染管理建议。他们都需要与抗菌药物相关的信息。此外,大多数人支持医生使用电子信息资源,包括应用程序。虽然目前只有少数人使用健康应用程序,但许多人认为应用程序可以用于提供与感染和抗菌药物合理使用相关的额外支持/信息。此外,我们发现医疗保健专业人员需要与患者接触,帮助解决围绕产生抗菌药物耐药性的常见误解。

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引用本文的文献

[1]
Using a mobile application to reduce potentially inappropriate prescribing for older Brazilian adults in primary care: a triple-blind randomised clinical trial.

BMC Geriatr. 2024-1-8

[2]
Use of stewardship smartphone applications by physicians and prescribing of antimicrobials in hospitals: A systematic review.

PLoS One. 2020-9-29

[3]
Beneficial Features of a mHealth Asthma App for Children and Caregivers: Qualitative Study.

JMIR Mhealth Uhealth. 2020-8-24

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JMIR Mhealth Uhealth. 2015-2-16

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JMIR Mhealth Uhealth. 2014-1-21

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