Institute of General Practice and Family Medicine, Faculty of Medicine, Friedrich-Schiller-University, Bachstrasse 18, 07743, Jena, Germany.
Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany.
Antimicrob Resist Infect Control. 2021 Apr 6;10(1):66. doi: 10.1186/s13756-021-00908-9.
Increasing antimicrobial resistance is a serious societal challenge affecting outpatient, inpatient and veterinary care. The German One-Health project, RAI (Rational use of Antibiotics via Information and Communication) addresses all three sectors. In the outpatient sector, General Practitioners (GPs) are the main prescribers of antibiotics and were therefore, targeted for this study. A multimodal intervention focusing on Acute Respiratory Tract infections (ARI) was designed and implemented. The aim of this study was to evaluate acceptance, rating and the self-reported impact of the intervention among GPs.
The intervention offered six tools: a GP training on rational antibiotic use, an app for self-monitoring, a leaflet and a set of posters (both for use as information materials in waiting rooms) and both digital and printed information prescriptions (material for 'prescribing' information instead of an antibiotic to the patient). The tools could be used according to individual preferences. The intervention was conducted between August 2016 and July 2017. Following the intervention, a three pages anonymous questionnaire was sent to all 271 participants. Items covered socio-demographic and professional background, use and judgement of the intervention tools (6 point Likert scale), impact of the intervention tools (4 point Likert scale).
The response rate was 39% (n = 107). On average, respondents used 3.1 of the six available tools, with printed information prescriptions used most frequently (79%). Digital information prescriptions were used more frequently by men than by women (OR 2.8; 95% CI 1.16-7.24; p = 0.02). Eighty-seven percent of respondents stated that information prescriptions supported doctor-patient communication. In a comparison of the overall impression of the different intervention tools the GP training on rational antibiotic use was rated best (1.67 on a 6 point scale with 1 = highest, 6 = lowest) and most often noted as having had a "strong" or "very strong" impact on personal antibiotic prescribing behavior.
The multimodal intervention addressing education and communication was well accepted among GPs and could help in fostering rational use of antibiotics in primary care.
抗菌药物耐药性不断增强是一个严重的社会挑战，影响着门诊、住院和兽医护理。德国的一项“One-Health”项目 RAI（通过信息和通信合理使用抗生素）针对所有这三个领域。在门诊领域，全科医生（GP）是抗生素的主要处方者，因此成为了这项研究的目标。设计并实施了一项针对急性呼吸道感染（ARI）的多模式干预措施。本研究旨在评估干预措施在 GP 中的接受程度、评价和自我报告的影响。
该干预措施提供了六种工具：GP 合理使用抗生素培训、自我监测应用程序、传单和一套海报（两者均用作候诊室的信息材料）以及数字和印刷信息处方（代替抗生素向患者开具信息的材料）。可以根据个人喜好使用这些工具。该干预措施于 2016 年 8 月至 2017 年 7 月进行。干预结束后，向所有 271 名参与者发送了一份三页的匿名问卷。项目涵盖了社会人口统计学和专业背景、干预工具的使用和判断（6 分李克特量表）、干预工具的影响（4 分李克特量表）。
回复率为 39%（n=107）。平均而言，受访者使用了 6 种可用工具中的 3.1 种，其中最常使用的是印刷信息处方（79%）。数字信息处方的使用频率男性高于女性（OR 2.8；95%CI 1.16-7.24；p=0.02）。87%的受访者表示信息处方支持医患沟通。在对不同干预工具的总体印象进行比较时，抗生素合理使用培训的评价最高（6 分制中得分为 1.67，1 分表示最高，6 分表示最低），并被大多数人认为对个人抗生素处方行为产生了“强烈”或“非常强烈”的影响。
针对教育和沟通的多模式干预措施在 GP 中得到了很好的接受，并有助于促进初级保健中抗生素的合理使用。
