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比较医院医生和初级保健医生对抗生素处方的态度与知识:葡萄牙中部地区的一项调查

Comparing Hospital and Primary Care Physicians' Attitudes and Knowledge Regarding Antibiotic Prescribing: A Survey within the Centre Region of Portugal.

作者信息

Rodrigues António Teixeira, Nunes João C F, Estrela Marta, Figueiras Adolfo, Roque Fátima, Herdeiro Maria Teresa

机构信息

Department of Medical Sciences, iBiMED-Institute of Biomedicine, University of Aveiro, 3800 Aveiro, Portugal.

Centre for Health Evaluation and Research (CEFAR), National Association of Pharmacies, 1249 Lisbon, Portugal.

出版信息

Antibiotics (Basel). 2021 May 25;10(6):629. doi: 10.3390/antibiotics10060629.

Abstract

BACKGROUND

Antibiotic resistance is a worldwide public health problem, leading to longer hospital stays, raising medical costs and mortality levels. As physicians' attitudes are key factors to antibiotic prescribing, this study sought to explore their differences between primary care and hospital settings.

METHODS

A survey was conducted between September 2011 and February 2012 in the center region of Portugal in the form of a questionnaire to compare hospital ( = 154) and primary care ( = 421) physicians' attitudes and knowledge regarding antibiotic prescribing.

RESULTS

More than 70% of the attitudes were statistically different ( < 0.05) between hospital physicians (HPs) and primary care physicians (PCPs). When compared to PCPs, HPs showed higher agreement with antibiotic resistances being a public health problem and ascribed more importance to microbiological tests and to the influence of prescription on the development of resistances. On the other hand, PCPs tended to agree more regarding the negative impact of self-medication with antibiotics dispensed without medical prescription and the need for rapid diagnostic tests. Seven out of nine sources of knowledge's usefulness were statistically different between both settings, with HPs considering most of the knowledge sources to be more useful than PCPs.

CONCLUSIONS

Besides the efforts made to improve both antibiotic prescribing and use, there are differences in the opinions between physicians working in different settings that might impact the quality of antibiotic prescribing. In the future, these differences must be considered to develop more appropriate interventions.

摘要

背景

抗生素耐药性是一个全球性的公共卫生问题,会导致住院时间延长、医疗成本增加以及死亡率上升。由于医生的态度是抗生素处方的关键因素,本研究旨在探讨初级医疗和医院环境中医生态度的差异。

方法

2011年9月至2012年2月期间,在葡萄牙中部地区以问卷调查的形式进行了一项调查,以比较医院医生(n = 154)和初级医疗医生(n = 421)在抗生素处方方面的态度和知识。

结果

医院医生(HPs)和初级医疗医生(PCPs)之间超过70%的态度在统计学上存在差异(P < 0.05)。与初级医疗医生相比,医院医生更认同抗生素耐药性是一个公共卫生问题,更重视微生物检测以及处方对耐药性发展的影响。另一方面,初级医疗医生在关于无医疗处方自行使用抗生素的负面影响以及快速诊断检测的必要性方面倾向于有更多的认同。在两种环境中,九种知识有用性来源中有七种在统计学上存在差异,医院医生认为大多数知识来源比初级医疗医生更有用。

结论

除了在改善抗生素处方和使用方面所做的努力外,不同环境下工作的医生之间的意见存在差异,这可能会影响抗生素处方的质量。未来,在制定更合适的干预措施时必须考虑这些差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3459/8229910/5e02c87faa6b/antibiotics-10-00629-g001.jpg

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