Mallah Narmeen, Figueiras Adolfo, Takkouche Bahi
Department of Preventive Medicine, University of Santiago de Compostela, R/ San Francisco, s/n, 15782, Santiago de Compostela, Spain.
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain.
Drug Saf. 2021 Jul;44(7):797-809. doi: 10.1007/s40264-021-01075-x. Epub 2021 May 10.
Cross-sectional studies on the association between knowledge, attitudes, and practices of antibiotic misuse are abundant. Conversely, longitudinal studies are unavailable.
The objective of this study was to compare findings from cross-sectional and longitudinal data analyses of the same study on knowledge and attitudes related to practices of antibiotic misuse in the general adult population.
A validated knowledge, attitudes, and practices questionnaire was self-administered at baseline and participants were followed up bimonthly. Logistic regression was used on baseline data to compute adjusted odds ratios in the cross-sectional data analysis. In the longitudinal approach, Poisson regression and generalized linear mixed models were used to estimate adjusted incidence rate ratios and adjusted odds ratios, respectively.
Seven hundred and forty-seven adults completed the baseline and the follow-up questionnaires. In the cross-sectional analysis, 78 participants misused antibiotics and strong associations were observed between agreement with various knowledge and attitudes statements and antibiotic misuse practices, with odds ratios between 1.94 and 5.66. In the longitudinal data analysis using Poisson regression, 46 events of antibiotic misuse were detected. No associations were observed between knowledge, attitudes, and misuse practices, except for two statements about the preference of storing antibiotics [adjusted incidence rate ratio: 2.33 (95% confidence interval 1.20-4.54)] and taking antibiotics when getting a cold [adjusted incidence rate ratio: 2.28 (95% confidence interval 1.24-4.21)]. The magnitude of these associations was lower than that observed in the cross-sectional analysis. Findings of the generalized linear mixed-model analysis were similar to those yielded by Poisson regression.
The cross-sectional and the longitudinal approaches yield divergent results in our setting. Risk of bias in both analyses should be scrutinized.
关于抗生素滥用的知识、态度和行为之间关联的横断面研究有很多。相反，纵向研究却难以获得。
本研究的目的是比较同一研究中关于一般成年人群抗生素滥用行为相关知识和态度的横断面和纵向数据分析结果。
在基线时自行填写一份经过验证的知识、态度和行为问卷，并对参与者每两个月进行一次随访。在横断面数据分析中，使用逻辑回归对基线数据计算调整后的比值比。在纵向研究中，分别使用泊松回归和广义线性混合模型来估计调整后的发病率比和调整后的比值比。
747名成年人完成了基线和随访问卷。在横断面分析中，78名参与者滥用抗生素，并且在对各种知识和态度陈述的认同与抗生素滥用行为之间观察到了强烈关联，比值比在1.94至5.66之间。在使用泊松回归的纵向数据分析中，检测到46起抗生素滥用事件。除了关于储存抗生素偏好的两条陈述[调整后的发病率比：2.33（95%置信区间1.20 - 4.54）]和感冒时服用抗生素[调整后的发病率比：2.28（95%置信区间1.24 - 4.21）]外，未观察到知识、态度与滥用行为之间的关联。这些关联的程度低于横断面分析中观察到的程度。广义线性混合模型分析的结果与泊松回归的结果相似。
在我们的研究环境中，横断面和纵向研究方法得出了不同的结果。两种分析中的偏倚风险都应受到审视。
