Community-based outpatient practice of antibiotics use in Tehran

Mohagheghi, Mohammad Ali; Mosavi‐Jarrahi, Alireza; Khatemi-Moghaddam, M.; Afhami, Shirin; Khodai, S.; Azemoodeh, O.

doi:10.1002/pds.1057

Cited by 19 publications

(22 citation statements)

References 10 publications

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“…In primary care (table 2 ), 33 studies (70%) [ 20 – 24 , 26 , 27 , 29 , 30 , 32 – 39 , 41 , 44 , 45 , 47 , 48 , 50 , 51 , 53 , 54 , 56 , 58 – 61 , 63 , 65 ] focused on the use of antibiotics in respiratory infections, and one focused on the use of antibiotics in infectious diseases and other infections (urinary infections, skin and soft tissue infections and septicemia) [ 27 ]; the remaining 30% failed to identify any target disease [ 25 , 28 , 31 , 40 , 42 , 43 , 46 , 49 , 52 , 55 , 57 , 62 , 64 , 66 ]. Of the 47 papers, 27 (57%) studied the efficacy/effectiveness of one or more interventions versus non-intervention, using a control group that received the intervention in four studies, dissemination of guideline information in three [ 56 , 57 , 65 ] and educational sessions on diagnosis of otitis media in one [ 58 ].…”

Section: Resultsmentioning

confidence: 99%

“…Physicians in the intervention group reported that they had changed their prescribing in the preceding 3 years. d In [ 40 ] , after one year, there was a reduction in the percentage of antibiotic prescribing in the intervention group but this was not statistically different from the control group. e In [ 42 ] , interventions resulted in improved antibiotic use, which was statistically significant in the Hanoi but not in the Bangkok study.…”

Section: Resultsmentioning

confidence: 99%

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Educational interventions to improve prescription and dispensing of antibiotics: a systematic review

et al. 2014

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BackgroundExcessive and inappropriate antibiotic use contributes to growing antibiotic resistance, an important public-health problem. Strategies must be developed to improve antibiotic-prescribing. Our purpose is to review of educational programs aimed at improving antibiotic-prescribing by physicians and/or antibiotic-dispensing by pharmacists, in both primary-care and hospital settings.MethodsWe conducted a critical systematic search and review of the relevant literature on educational programs aimed at improving antibiotic prescribing and dispensing practice in primary-care and hospital settings, published in January 2001 through December 2011.ResultsWe identified 78 studies for analysis, 47 in primary-care and 31 in hospital settings. The studies differed widely in design but mostly reported positive results. Outcomes measured in the reviewed studies were adherence to guidelines, total of antibiotics prescribed, or both, attitudes and behavior related to antibiotic prescribing and quality of pharmacy practice related to antibiotics. Twenty-nine studies (62%) in primary care and twenty-four (78%) in hospital setting reported positive results for all measured outcomes; fourteen studies (30%) in primary care and six (20%) in hospital setting reported positive results for some outcomes and results that were not statistically influenced by the intervention for others; only four studies in primary care and one study in hospital setting failed to report significant post-intervention improvements for all outcomes. Improvement in adherence to guidelines and decrease of total of antibiotics prescribed, after educational interventions, were observed, respectively, in 46% and 41% of all the reviewed studies. Changes in behaviour related to antibiotic-prescribing and improvement in quality of pharmacy practice was observed, respectively, in four studies and one study respectively.ConclusionThe results show that antibiotic use could be improved by educational interventions, being mostly used multifaceted interventions.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2458-14-1276) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Educational interventions to improve prescription and dispensing of antibiotics: a systematic review

et al. 2014

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“…Previous studies in the region indicate that educational interventions alone have limited impact (49)(50)(51) but in many successful multifaceted interventions, educational components are included (9,17,52,53). Enablement interventions are speci c for intervening on factors that block the behavior change (8) Mitchie et al 2013).…”

Section: Discussionmentioning

confidence: 99%

Designing an Evidence-Based Behavior Change Strategy to Promote Antibiotic Use in Primary Healthcare in Gezira State, Sudan

Lohiniva

Elwali²,

Abuobaida³

et al. 2020

Preprint

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Background: Abuse of antibiotics is a major contributing factor to the emergence of antibiotic resistance (ABR) globally. Misuse and overuse of antibiotics is common also in Sudan. Addressing antibiotic use is a key component of AMR response.Objectives: The project aimed to develop a theory driven behavior change strategy based on local understanding of drivers of antibiotic use at primary healthcare settings in Gezira State in Sudan. The strategy is needed to enhance the prescribers’ appropriate prescription of antibiotics and to reduce the patient’s demand towards unnecessary antibiotics.Methods: The strategy was designed based on the Theoretical Domains Framework (TDF) to identify behavioral barriers and the Behavior Change Wheel to select appropriate behavior change techniques (BCTs). The process included two major elements (1) a formative qualitative research study using focus group discussions and in-depth interviews targeting prescribers and patients. (2) a knowledge co-production workshop that utilized the results of the qualitative study and aimed to design a salient, legitimate and credible behavior change strategy identifying relevant behavior change techniques (BCTs) to overcome key barriers.Results: The main TDF domains that emerged from the discussions with prescribers were knowledge of antibiotics and AMR, skills to answer patient demand on antibiotics, prescription habits and work exhaustion, social influences, intention to change prescription practices and environmental factors. The main TDF domains that emerged through discussions with patients were antibiotic use habits, social influences, professional role belief in capabilities and intention to change. The workshop discussions resulted in the selection of five BTCs that included education, training, modeling, enablement and persuasion.Conclusion: This study, using the TDF and BCW taxonomy, explored the fact that antibiotic prescribing is influenced by many social and contextual factors. Knowledge co- production offered real benefits in addressing these complexities to come up with a set of context appropriate behavior change interventions.

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“…Additionally, four studies were excluded because they reported antibiotic prescribing by health workers other than medical doctors, such as paramedical workers, nurses, pharmacists and trained lay persons. Finally, eight studies (describing ten interventions) met all the inclusion criteria and were included in the review [40][41][42][43][44][45][46][47].…”

Section: Literature Review Outcomementioning

confidence: 99%

Interventions to Improve Antibiotic Prescribing in Upper Middle Income Countries: A Systematic Review of the Literature 1990 - 2009

Ivanovska

Holloway

2013

Maced J Med Sci

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Community-based outpatient practice of antibiotics use in Tehran

Abstract: Irrational use of antibiotics can improve by appropriate educational intervention, using CME programs.

Cited by 19 publications

References 10 publications

Educational interventions to improve prescription and dispensing of antibiotics: a systematic review

Educational interventions to improve prescription and dispensing of antibiotics: a systematic review

Designing an Evidence-Based Behavior Change Strategy to Promote Antibiotic Use in Primary Healthcare in Gezira State, Sudan

Interventions to Improve Antibiotic Prescribing in Upper Middle Income Countries: A Systematic Review of the Literature 1990 - 2009

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