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针对基层和社区医疗机构中患者因呼吸道感染寻求抗生素治疗行为的行为改变干预措施:一项范围综述

Behaviour change interventions addressing patient antibiotic treatment-seeking behaviour for respiratory tract infections in primary and community care settings: a scoping review.

作者信息

Maher Anthony, Roche Kevin, Morrissey Eimear, Murphy Andrew, Sheaf Greg, Ryan Cristín, Molloy Gerard J

机构信息

School of Psychology, University of Galway College of Arts Social Sciences and Celtic Studies, Galway, Ireland

University of Galway College of Arts Social Sciences and Celtic Studies, Galway, Ireland.

出版信息

BMJ Open. 2025 Aug 5;15(8):e101694. doi: 10.1136/bmjopen-2025-101694.

Abstract

OBJECTIVES

This scoping review aimed to map studies on behaviour change interventions that address antibiotic treatment-seeking behaviour for respiratory tract infections in primary and community care settings.

DESIGN

This review is based on the Joanna Briggs Institute guidelines for scoping reviews, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.

DATA SOURCES

A literature search in January 2024 and May 2024 was performed across Medline, Embase, CINAHL, PsycINFO, Web of Science Core Collection, Scopus, EThOS and Google Scholar was performed.

ELIGIBILITY CRITERIA

Eligible studies described behaviour change interventions in primary and community care settings, published from 2000 onward across all countries.

DATA EXTRACTION AND SYNTHESIS

Descriptive data relating to study details and intervention functions were gathered and organised according to the Capability, Opportunity, Motivation and Behaviour change framework in a predeveloped data extraction sheet. Dual data extraction occurred, and inter-rater reliability results are reported (K=0.83).

RESULTS

The scoping review identified 38 eligible studies, which consisted of randomised controlled trials (7/38), cluster randomised controlled trials (6/38), randomised experiments (5/38), cross-sectional studies (5/38), qualitative investigations (5/38) and quasi-experimental designs (4/38). Most interventions focused on educational resources (15/38), digital tools (7/38) and community campaigns (6/38), with fewer targeting decision-making processes (4/38) or psychological drivers of antibiotic-seeking behaviour (3/38). Only one study was conducted in low-income and middle-income countries, and only one separately assessed behaviour change as a measured outcome.

CONCLUSIONS

This scoping review highlights a wide range of research methodologies within the topic area. There was some limited evidence of intervention efficacy for antibiotic prescription rates, particularly interventions focused on enhancing knowledge and access to resources. However, more emphasis is needed on standardising outcome measures and evaluating long-term outcomes.

摘要

目的

本范围综述旨在梳理关于行为改变干预措施的研究,这些措施旨在解决基层和社区医疗环境中呼吸道感染抗生素治疗寻求行为问题。

设计

本综述基于乔安娜·布里格斯研究所的范围综述指南,并遵循系统评价与Meta分析优先报告项目的范围综述扩展版。

数据来源

于2024年1月和5月在Medline、Embase、CINAHL、PsycINFO、科学引文索引核心合集、Scopus、英国国家论文数据库和谷歌学术进行了文献检索。

纳入标准

符合条件的研究描述了2000年以来在所有国家基层和社区医疗环境中的行为改变干预措施。

数据提取与综合

收集了与研究细节和干预功能相关的描述性数据,并根据能力、机会、动机和行为改变框架,整理到预先制定的数据提取表中。进行了双人数据提取,并报告了评分者间信度结果(K=0.83)。

结果

范围综述确定了38项符合条件的研究,其中包括随机对照试验(7/38)、整群随机对照试验(6/38)、随机实验(5/38)、横断面研究(5/38)、定性研究(5/38)和准实验设计(4/38)。大多数干预措施侧重于教育资源(15/38)、数字工具(7/38)和社区宣传活动(6/38),针对决策过程(4/38)或抗生素寻求行为心理驱动因素(3/38)的较少。只有一项研究在低收入和中等收入国家开展,且只有一项单独将行为改变作为测量结果进行评估。

结论

本范围综述突出了该主题领域广泛的研究方法。关于抗生素处方率的干预效果存在一些有限的证据,特别是侧重于增强知识和资源获取的干预措施。然而,需要更多地强调标准化结果测量并评估长期结果。

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