Rocha Vânia, Estrela Marta, Neto Vanessa, Roque Fátima, Figueiras Adolfo, Herdeiro Maria Teresa
Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal.
Research Unit for Inland Development, Polytechnic of Guarda (UDI-IPG), 6300-559 Guarda, Portugal.
Antibiotics (Basel). 2022 Sep 2;11(9):1186. doi: 10.3390/antibiotics11091186.
Antibiotic resistance remains a crucial global public health problem with excessive and inappropriate antibiotic use representing an important driver of this issue. Strategies to improve antibiotic prescription and dispensing are required in primary health care settings. The main purpose of this review is to identify and synthesize available evidence on the economic impact of educational interventions to reduce prescription and dispensing of antibiotics among primary health care professionals. Information about the clinical impact resulting from the implementation of interventions was also gathered. PubMed, Scopus, Web of Science and EMBASE were the scientific databases used to search and identify relevant studies. Of the thirty-three selected articles, most consisted of a simple intervention, such as a guideline implementation, while the others involved multifaceted interventions, and differed regarding study populations, designs and settings. Main findings were grouped either into clinical or cost outcomes. Twenty of the thirty-three articles included studies reporting a reduction in outcome costs, namely in antibiotic cost and associated prescription costs, in part due to an overall improvement in the appropriateness of antibiotic use. The findings of this study show that the implementation of educational interventions is a cost-effective strategy to reduce antibiotic prescription and dispensing among primary healthcare providers.
抗生素耐药性仍然是一个关键的全球公共卫生问题，抗生素的过度和不当使用是这一问题的重要驱动因素。初级卫生保健机构需要采取策略来改善抗生素的处方和配药情况。本综述的主要目的是识别和综合关于教育干预措施对减少初级卫生保健专业人员抗生素处方和配药的经济影响的现有证据。同时还收集了干预措施实施所产生的临床影响的信息。PubMed、Scopus、科学网和EMBASE是用于检索和识别相关研究的科学数据库。在所选的33篇文章中，大多数文章包含简单干预措施，如指南实施，而其他文章涉及多方面干预措施，且在研究人群、设计和环境方面存在差异。主要研究结果分为临床结果或成本结果。33篇文章中有20篇研究报告了结果成本的降低，即抗生素成本和相关处方成本的降低，部分原因是抗生素使用的适宜性总体有所改善。本研究结果表明，实施教育干预措施是减少初级卫生保健提供者抗生素处方和配药的一种具有成本效益的策略。
