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初级保健中采用抗菌药物管理计划的障碍和促进因素:定性研究。

Barriers and facilitators to the uptake of an antimicrobial stewardship program in primary care: A qualitative study.

机构信息

Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada.

Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michaels Hospital, Toronto, Ontario, Canada.

出版信息

PLoS One. 2020 Mar 5;15(3):e0223822. doi: 10.1371/journal.pone.0223822. eCollection 2020.

Abstract

The overuse of antimicrobials in primary care can be linked to an increased risk of antimicrobial-resistant bacteria for individual patients. Although there are promising signs of the benefits associated with Antimicrobial Stewardship Programs (ASPs) in hospitals and long-term care settings, there is limited knowledge in primary care settings and how to implement ASPs in these settings is unclear. In this context, a qualitative study was undertaken to explore the perceptions of primary care prescribers of the usefulness, feasibility, and experiences associated with the implementation of a pilot community-focused ASP intervention in three primary care clinics. Qualitative interviews were conducted with primary care clinicians, including local ASP champions, prescribers, and other primary health care team members, while they participated in an ASP initiative within one of three primary care clinics. An iterative conventional content analyses approach was used to analyze the transcribed interviews. Themes emerged around the key enablers and barriers associated with ASP implementation. Study findings point to key insights relevant to the scalability of community ASP activities with primary care providers.

摘要

在初级保健中过度使用抗菌药物可能会导致个体患者对抗菌药物耐药菌的风险增加。尽管医院和长期护理机构中的抗菌药物管理计划(ASPs)带来了一些有希望的好处迹象,但在初级保健环境中相关知识有限,如何在这些环境中实施 ASP 尚不清楚。在这种情况下,进行了一项定性研究,以探讨初级保健开处方者对在三个初级保健诊所实施以社区为重点的试点 ASP 干预措施的有用性、可行性和相关经验的看法。对初级保健临床医生进行了定性访谈,包括当地 ASP 拥护者、处方者和其他初级卫生保健团队成员,他们参与了三个初级保健诊所之一的 ASP 计划。使用迭代常规内容分析方法对转录的访谈进行了分析。主题围绕与 ASP 实施相关的主要促成因素和障碍展开。研究结果指出了与社区 ASP 活动与初级保健提供者的可扩展性相关的关键见解。

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