Department of Health Management, School of Public Health, Fujian Medical University, Room 108 in the Building for School of Public Health, 1 Xuefubei Road, Minhou District, Fuzhou, 350122, China.
BMC Health Serv Res. 2020 Apr 6;20(1):282. doi: 10.1186/s12913-020-05171-z.
Nowadays, irrational use of antimicrobials has threatened public health. It's necessary to expand the use of clinical practice guideline (CPG) on antimicrobial for facilitating the proper use of antimicrobial. However, the utilization status of CPG on antimicrobial and the influencing factors, especially the ones at the organizational level, remain largely unknown.
A cross-sectional questionnaire survey was conducted on a sample among physicians from 16 public hospitals in the eastern, central and western parts of China. A multilevel regression model was employed to examine factors associated with physicians' utilization of CPG on antimicrobial.
A total of 815 physicians were included in this study. About 80% of the surveyed physicians reported their adherence to the CPG on antimicrobial. Dimensions of "subjective norm", "perceived risk" and "behavioral intention" from the domain of physician belief, a dimension of "ease of use" from the domain of CPG traits, and dimensions of "top management support" and "organization & implementation" from the domain of hospital practice were significantly associated with physicians' utilization of CPG on antimicrobial. And except for working department, most demographics characteristics of the physician were not found to be significantly related to the CPG use. In addition, it also showed that region is a significant factor affecting physicians' CPG use.
This study depicted the current status of CPG on antimicrobial and comprehensively identified its potential determinants not only from the three domains at the individual level, such as physician belief, but also from the location region at the organizational level. The results will provide a direct reference for the implementation of CPG on antimicrobial.
如今，抗菌药物的不合理使用已经威胁到公众健康。有必要扩大临床实践指南（CPG）在抗菌药物使用方面的应用，以促进抗菌药物的合理使用。然而，抗菌药物 CPG 的使用现状及其影响因素，特别是组织层面的影响因素，在很大程度上仍不清楚。
采用横断面问卷调查的方法，对来自中国东部、中部和西部地区 16 家公立医院的医生进行抽样调查。采用多水平回归模型分析与医生抗菌药物 CPG 使用相关的因素。
共纳入 815 名医生。约 80%的调查医生表示他们遵循抗菌药物 CPG。医生信念领域的“主观规范”、“感知风险”和“行为意向”维度，CPG 特征领域的“易用性”维度，以及医院实践领域的“高层管理支持”和“组织与实施”维度与医生抗菌药物 CPG 的使用显著相关。除了工作科室外，医生的大多数人口统计学特征与 CPG 使用均无显著相关性。此外，研究还表明，地域是影响医生 CPG 使用的一个重要因素。
本研究描绘了抗菌药物 CPG 的现状，并从医生信念等个体层面的三个领域，以及组织层面的地域位置，全面识别了其潜在的决定因素。研究结果将为抗菌药物 CPG 的实施提供直接参考。
