Biomedical Informatics and Digital Health, School of Medical Sciences, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia.
J Am Med Inform Assoc. 2022 Sep 12;29(10):1786-1796. doi: 10.1093/jamia/ocac125.
To understand and synthesize factors influencing user acceptance of digital interventions used for antimicrobial prescribing and monitoring in hospitals.
A meta-synthesis was conducted to identify qualitative studies that explored user acceptance of digital interventions for antimicrobial prescribing and/or monitoring in hospitals. Databases were searched and qualitative data were extracted and systematically classified using the unified theory of acceptance and use of technology (UTAUT) model.
Fifteen qualitative studies met the inclusion criteria. Eleven papers used interviews and four used focus groups. Most digital interventions evaluated in studies were decision support for prescribing (n = 13). Majority of perceptions were classified in the UTAUT performance expectancy domain in perceived usefulness and relative advantage constructs. Key facilitators in this domain included systems being trusted and credible sources of information, improving performance of tasks and increasing efficiency. Reported barriers were that interventions were not considered useful for all settings or patient conditions. Facilitating conditions was the second largest domain, which highlights the importance of users having infrastructure to support system use. Digital interventions were viewed positively if they were compatible with values, needs, and experiences of users.
User perceptions that drive users to accept and utilize digital interventions for antimicrobial prescribing and monitoring were predominantly related to performance expectations and facilitating conditions. To ensure digital interventions for antimicrobial prescribing are accepted and used, we recommend organizations ensure systems are evaluated and benefits are conveyed to users, that utility meets expectations, and that appropriate infrastructure is in place to support use.
了解和综合影响医院中用于抗菌药物处方和监测的数字干预措施用户接受度的因素。
进行了元综合分析，以确定探索医院中用于抗菌药物处方和/或监测的数字干预措施用户接受度的定性研究。检索数据库并提取定性数据，并使用统一技术接受和使用理论（UTAUT）模型进行系统分类。
符合纳入标准的有 15 项定性研究。11 篇论文采用了访谈，4 篇论文采用了焦点小组。研究中评估的大多数数字干预措施是用于处方的决策支持（n=13）。大多数感知被归类为 UTAUT 感知有用性和相对优势结构中的绩效期望领域。该领域的主要促进因素包括系统被信任和信息的可靠来源、提高任务绩效和提高效率。报告的障碍是干预措施被认为不适用于所有环境或患者情况。促进条件是第二大领域，这突出了用户拥有支持系统使用的基础设施的重要性。如果数字干预措施与用户的价值观、需求和经验相契合，则被认为是积极的。
驱动用户接受和使用抗菌药物处方和监测数字干预措施的用户感知主要与绩效期望和促进条件有关。为确保抗菌药物处方的数字干预措施被接受和使用，我们建议组织确保对系统进行评估并向用户传达收益，使效用符合预期，并为支持使用提供适当的基础设施。
