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卡塔尔初级卫生保健中心合理抗生素处方的障碍:医生和药剂师的观点。

Barriers of Appropriate Antibiotic Prescription at PHCC in Qatar: Perspective of Physicians and Pharmacists.

作者信息

Sharaf Nahla, Al-Jayyousi Ghadir Fakhri, Radwan Eman, Shams Eldin Shimous Mohamed Elamin, Hamdani Dhouha, Al-Katheeri Huda, Elawad Khalid, Habib Sair Anjum

机构信息

Department of Strategic Planning and Performance, Ministry of Public Health, Doha P.O. Box 42, Qatar.

Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar.

出版信息

Antibiotics (Basel). 2021 Mar 19;10(3):317. doi: 10.3390/antibiotics10030317.

Abstract

The Ministry of Public Health in Qatar developed the NAP (National Action Plan to combat Antimicrobial Resistance (AMR) in collaboration with WHO Regional Office for the Eastern Mediterranean (WHO/EMRO). Among the major factors shaping AMR is antimicrobial prescribing and use. Tailoring Antimicrobial Resistance Program is a behavior change methodology that is utilized to adapt behavior change in relation to antimicrobial use. This study explores barriers of appropriate antibiotic (AB) prescription from the physicians' and pharmacists' perspectives at primary healthcare centers in Qatar. Data were collected from 50 participants across two PHCCs: 30 physicians and 20 pharmacists. Two different interview guides were constructed: One for physicians and one for pharmacists. In-depth, face-to-face, five focus groups were conducted and transcribed verbatim. Inductive qualitative analysis, involving discovering the themes in the interviews, was followed. Data were analyzed using constant comparative techniques. The Major themes arose from the analysis revealed that patients, practitioners mainly physicians, and the organization itself, played a role in shaping these barriers in the two primary healthcare centers. The findings would help develop and pilot behavior change interventions among patients, physicians and pharmacists with the aim of optimizing appropriate antibiotic prescription and use, which would support the implementation of the antibiotic stewardship program. Effective behavior change interventions should consider multiple factors including individual and organizational factors to optimize appropriate antibiotic prescription.

摘要

卡塔尔公共卫生部与世界卫生组织东地中海区域办事处(WHO/EMRO)合作制定了《抗击抗菌药物耐药性国家行动计划》(NAP)。影响抗菌药物耐药性的主要因素之一是抗菌药物的处方和使用。定制抗菌药物耐药性计划是一种行为改变方法,用于调整与抗菌药物使用相关的行为变化。本研究从卡塔尔初级医疗保健中心医生和药剂师的角度探讨了合理抗生素(AB)处方的障碍。数据来自两个初级医疗保健中心的50名参与者:30名医生和20名药剂师。构建了两种不同的访谈指南:一种针对医生,一种针对药剂师。进行了五次深入的面对面焦点小组讨论,并逐字记录。随后采用归纳定性分析,即在访谈中发现主题。使用持续比较技术对数据进行分析。分析得出的主要主题表明,患者、从业者(主要是医生)以及组织本身在两个初级医疗保健中心形成这些障碍方面发挥了作用。这些发现将有助于在患者、医生和药剂师中开发和试行行为改变干预措施,以优化合理抗生素处方和使用,这将支持抗生素管理计划的实施。有效的行为改变干预措施应考虑包括个人和组织因素在内的多个因素,以优化合理抗生素处方。

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