Determinants of Physicians’ Intention to Use Clinical Practice Guidelines on Antimicrobial at Tertiary General Hospitals in China

Abstract

Background: Inappropriate use of antimicrobial has resulted in some great public health concerns, such as antimicrobial resistance (AMR). Although the effects of clinical guidelines in standardizing clinical practice, controlling costs and reducing medical risks have been proved, the CPGs on antimicrobial hasn’t been widely applied in China yet. Furthermore, the influencing mechanism for the intention to the use of CPGs on antimicrobial remains largely unknown. Methods: By summarizing the relevant literature, the research model and self-administered questionnaire were developed. A national cross-sectional survey was conducted among physicians at tertiary general hospitals in the eastern, central, and western parts of China. Results: A total of 644 valid questionnaires were collected. The results of reliability and validity analysis showed the questionnaire was acceptable. The analyses of structural equation modeling (SEM) showed the proposed model fitted the data well with favorable values of fit indices. SEM results also revealed that seven determinants influence the intention to the use of CPGs on antimicrobial, including attitude (ATT), subjective norm (SN), perceived risk (PR), relative advantage (RA), ease of use (EOU), top management support (TMS) and organization & implementation (OI). Conclusions: The findings of this study revealed the significance of multifaceted factors to enhance the intention to use CPGs on antimicrobial. These findings will not only contribute to the development of targeted intervention strategies on promoting the use of CPGs on antimicrobial, but also provide insights for future studies about physicians’ adoption behaviors on certain health services or products.