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理论在开发和评估行为改变干预措施以改善抗菌药物处方方面的应用：系统评价。

The use of theory in the development and evaluation of behaviour change interventions to improve antimicrobial prescribing: a systematic review.

机构信息

School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, UK.

College of Pharmacy, QU Health, Qatar University, Doha, Qatar.

出版信息

J Antimicrob Chemother. 2020 Sep 1;75(9):2394-2410. doi: 10.1093/jac/dkaa154.

DOI:10.1093/jac/dkaa154
PMID:32356877
Abstract

OBJECTIVES

This systematic review (SR) reviews the evidence on use of theory in developing and evaluating behaviour change interventions (BCIs) to improve clinicians' antimicrobial prescribing (AP).

METHODS

The SR protocol was registered with PROSPERO. Eleven databases were searched from inception to October 2018 for peer-reviewed, English-language, primary literature in any healthcare setting and for any medical condition. This included research on changing behavioural intentions (e.g. in simulated scenarios) and research measuring actual AP. All study designs/methodologies were included. Excluded were: grey literature and/or those which did not state a theory. Two reviewers independently extracted and quality assessed the data. The Theory Coding Scheme (TCS) evaluated the extent of the use of theory.

RESULTS

Searches found 4227 potentially relevant papers after removal of duplicates. Screening of titles/abstracts led to dual assessment of 38 full-text papers. Ten (five quantitative, three qualitative and two mixed-methods) met the inclusion criteria. Studies were conducted in the UK (n = 8), Canada (n = 1) and Sweden (n = 1), most in primary care settings (n = 9), targeting respiratory tract infections (n = 8), and medical doctors (n = 10). The most common theories used were Theory of Planned Behaviour (n = 7), Social Cognitive Theory (n = 5) and Operant Learning Theory (n = 5). The use of theory to inform the design and choice of intervention varied, with no optimal use as recommended in the TCS.

CONCLUSIONS

This SR is the first to investigate theoretically based BCIs around AP. Few studies were identified; most were suboptimal in theory use. There is a need to consider how theory is used and reported and the systematic use of the TCS could help.

摘要

目的

本系统评价（SR）综述了将理论应用于开发和评估行为改变干预措施（BCIs）以改善临床医生抗菌药物处方（AP）的证据。

方法

该 SR 方案在 PROSPERO 上进行了注册。从成立到 2018 年 10 月，我们在 11 个数据库中搜索了同行评审的、以英语为母语的、在任何医疗保健环境中针对任何医疗条件的原始文献。这包括研究改变行为意向（例如在模拟场景中）和测量实际 AP 的研究。包括所有研究设计/方法。排除了灰色文献和/或未说明理论的文献。两位审查员独立提取和评估数据。理论编码方案（TCS）评估了理论使用的程度。

结果

在去除重复项后，搜索发现了 4227 篇潜在相关的论文。对标题/摘要进行筛选后，对 38 篇全文论文进行了双重评估。符合纳入标准的有 10 篇（5 篇定量、3 篇定性和 2 篇混合方法）。这些研究分别在英国（n=8）、加拿大（n=1）和瑞典（n=1）进行，主要在初级保健环境中（n=9），针对呼吸道感染（n=8），目标人群为医生（n=10）。使用最多的理论是计划行为理论（n=7）、社会认知理论（n=5）和操作性学习理论（n=5）。理论用于指导设计和选择干预措施的方式各不相同，没有按照 TCS 建议的最佳方式使用理论。

结论

这是首次针对抗菌药物处方的基于理论的 BCIs 进行的 SR。确定的研究很少；大多数研究在理论应用方面并不理想。需要考虑如何使用和报告理论，系统使用 TCS 可能会有所帮助。

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Antibiotics (Basel). 2023 Mar 8;12(3):540. doi: 10.3390/antibiotics12030540.
4
Theoretically derived interventions aimed at improving appropriate polypharmacy in primary care: A systematic review.旨在改善基层医疗中合理联合用药的理论推导干预措施：一项系统综述。
Explor Res Clin Soc Pharm. 2022 Aug 9;7:100166. doi: 10.1016/j.rcsop.2022.100166. eCollection 2022 Sep.
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Tipping the balance: A systematic review and meta-ethnography to unfold the complexity of surgical antimicrobial prescribing behavior in hospital settings.颠覆平衡：一项系统评价和荟萃民族志研究，旨在揭示医院环境中外科抗菌药物处方行为的复杂性。
PLoS One. 2022 Jul 20;17(7):e0271454. doi: 10.1371/journal.pone.0271454. eCollection 2022.
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A Scoping Review of the Use of Social and Behavioral Change in Acute Care Antimicrobial Stewardship Initiatives.急性护理抗菌药物管理举措中社会与行为改变运用的范围综述
Hosp Pharm. 2022 Feb;57(1):138-145. doi: 10.1177/0018578721990887. Epub 2021 Feb 1.
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The theoretical basis of a nationally implemented type 2 diabetes prevention programme: how is the programme expected to produce changes in behaviour?国家实施的 2 型糖尿病预防计划的理论基础：该计划预计如何改变行为？
Int J Behav Nutr Phys Act. 2021 May 13;18(1):64. doi: 10.1186/s12966-021-01134-7.
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Are we speaking the same language? Call for action to improve theory application and reporting in behaviour change research.我们说的是同一种语言吗？呼吁采取行动，改善行为改变研究中的理论应用和报告。
BMC Public Health. 2021 Mar 10;21(1):479. doi: 10.1186/s12889-021-10541-1.