Hughes Ashley M, Evans Charlesnika T, Fitzpatrick Margaret A, Kale Ibuola O, Vivo Amanda, Boyer Taylor L, Solanki Pooja A, Gibson Gretchen, Jurasic M Marianne, Sharp Lisa K, Echevarria Kelly L, Suda Katie J
Department of Biomedical and Health Information Sciences, University of Illinois Chicago, Chicago, Illinois.
Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, US Department of VA, Hines, Illinois.
Antimicrob Steward Healthc Epidemiol. 2022 Jun 24;2(1):e102. doi: 10.1017/ash.2022.242. eCollection 2022.
To understand barriers and facilitators to evidence-based prescribing of antibiotics in the outpatient dental setting.
Semistructured interviews.
Outpatient dental setting.
Dentists from 40 Veterans' Health Administration (VA) facilities across the United States.
Dentists were identified based on their prescribing patterns and were recruited to participate in a semistructured interview on perceptions toward prescribing. All interviews were recorded, transcribed, and double-coded for analysis, with high reliability between coders. We identified general trends using the theoretical domains framework and mapped overarching themes onto the behavior change wheel to identify prospective interventions that improve evidence-based prescribing.
In total, 90 dentists participated in our study. The following barriers and facilitators to evidence-based prescribing emerged as impacts on a dentist's decision making on prescribing an antibiotic: access to resources, social influence of peers and other care providers, clinical judgment, beliefs about consequences, local features of the clinic setting, and beliefs about capabilities.
Findings from this work reveal the need to increase awareness of up-to-date antibiotic prescribing behaviors in dentistry and may inform the best antimicrobial stewardship interventions to support dentists' ongoing professional development and improve evidence-based prescribing.
了解门诊牙科环境中抗生素循证处方的障碍和促进因素。
半结构化访谈。
门诊牙科环境。
来自美国40个退伍军人健康管理局（VA）机构的牙医。
根据牙医的处方模式确定人选，并招募他们参与关于处方观念的半结构化访谈。所有访谈均进行录音、转录和双重编码以进行分析，编码员之间的信度很高。我们使用理论领域框架确定总体趋势，并将总体主题映射到行为改变轮上，以确定改善循证处方的前瞻性干预措施。
共有90名牙医参与了我们的研究。以下抗生素循证处方的障碍和促进因素成为影响牙医开具抗生素处方决策的因素：资源获取、同行和其他医疗服务提供者的社会影响、临床判断、对后果的看法、诊所环境的局部特征以及对自身能力的看法。
这项工作的结果表明有必要提高对牙科最新抗生素处方行为的认识，并可能为最佳抗菌药物管理干预措施提供信息，以支持牙医的持续专业发展并改善循证处方。
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