Yan Yuxing, Yang Junli, Lu Yun, Cui Zhezhe, Chang Yue
School of Medicine and Health Management, Guizhou Medical University, Guiyang, Guizhou Province, People's Republic of China.
School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou Province, People's Republic of China.
Infect Drug Resist. 2025 Jan 6;18:61-76. doi: 10.2147/IDR.S492367. eCollection 2025.
To evaluate the long-term impacts of the feedback intervention on controlling inappropriate use of antimicrobial prescriptions in primary care institutions in China, as a continuation of the previous feedback intervention trial.
After the intervention ended, we conducted a 12-month follow-up study. The prescription data were collected from the baseline until the end of the follow-up period. The generalized estimation equation was employed to analyze the differences among four representative time points: at the baseline point, at 3 months, at 6 months, and at 18 months. The time-intervention interaction was utilized to evaluate the changing trends of group A and group B. Our primary outcome variable is the monthly inappropriate antimicrobial prescription rate (IAPR).
After adjusting for covariates, the IAPRs in group A decreased by 1.00% on average from the baseline point to the 3 months, 5.00% from the 3 months to the 6 months, -0.92% from the 6 months to the 18 months, and 0.39% from the baseline point to the 18 months. During the corresponding four periods in group B, the average decline was 2.33%, 3.67%, -0.42%, and 0.72%, respectively. As for antimicrobial prescription rates (APRs), the average decline for group A was 1.33%, 3.67%, and 0.17% during the three periods: from the baseline point to the 3 months, from the 3 months to the 6 months, and from the 6 months to the 18 months, respectively. Accordingly in group B, the average decline was 1.00%, 3.67%, and 0.08%, respectively.
Our feedback intervention generated limited long-term impacts. Although the IAPRs and the APRs consistently remained below the baseline point, both rates experienced a rebound within a certain range following the stop of the intervention in the two groups. It is reasonable to think that the desired effects will be difficult to maintain without sustained implementation of feedback intervention.
作为之前反馈干预试验的延续，评估反馈干预对控制中国基层医疗机构抗菌药物处方不合理使用的长期影响。
干预结束后，我们进行了为期12个月的随访研究。收集从基线到随访期结束的处方数据。采用广义估计方程分析四个代表性时间点（基线点、3个月、6个月和18个月）之间的差异。利用时间-干预交互作用评估A组和B组的变化趋势。我们的主要结局变量是每月不合理抗菌药物处方率（IAPR）。
在调整协变量后，A组的IAPR从基线点到3个月平均下降1.00%，从3个月到6个月下降5.00%，从6个月到18个月下降-0.92%，从基线点到18个月下降0.39%。在B组的相应四个时期，平均下降分别为2.33%、3.67%、-0.42%和0.72%。至于抗菌药物处方率（APR），A组在从基线点到3个月、从3个月到6个月以及从6个月到18个月这三个时期的平均下降分别为1.33%、3.67%和0.17%。相应地，B组的平均下降分别为1.00%、3.67%和0.08%。
我们的反馈干预产生的长期影响有限。尽管IAPR和APR一直保持在基线点以下，但两组在干预停止后，这两个率在一定范围内都出现了反弹。可以合理地认为，如果不持续实施反馈干预，期望的效果将难以维持。
