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

Ivanovska, Verica; Holloway, Kathleen

doi:10.3889/mjms.1857-5773.2012.0268

Cited by 4 publications

(2 citation statements)

References 31 publications

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“…The following studies highlighted the positive effects produced by educational actions through different approaches: educational performance of pharmacists (Ross and Loke, 2009; Tesfaye et al, 2017); actions that improve the transfer of information among prescribers and discussion of cases in the multidisciplinary team in long–term care facilities for the elderly (Alldred et al, 2016); educational actions with multidisciplinary teams (Chiatti et al, 2012); distribution of clinical protocols and therapeutic guidelines, educational meetings, audit and feedback (Arnold and Straus, 2005); small group workshops, use of decision trees, sharing of quarterly reports, and annual educational actions (Kaur et al, 2009); educational initiatives dissemination, targeted studies and meetings with the participation of professionals (Forsetlund et al, 2011); use of web-based education program, use of performance feedback, along with patient and clinician education, direct and individualized education actions (Brennan and Mattick, 2013); multifaceted interventions (Brennan and Mattick, 2013; Ivanovska and Holloway, 2013; Roque et al, 2014; Coxeter et al, 2015); educational actions that promote behavior change (Tonkin-Crine et al, 2011) tailored to antimicrobial stewardship teams (Davey et al, 2017); interactive educational workshops with reinforcement by a local opinion leader (Fleming et al, 2013).…”

Section: Policy Options For Preventing or Reducing Prescribing Errorsmentioning

confidence: 99%

How to Prevent or Reduce Prescribing Errors: An Evidence Brief for Policy

et al. 2019

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- Preventing prescribing errors is critical to improving patient safety. - We developed an evidence brief for policy to identify effective interventions to avoid or reduce prescribing errors. - Four options were raised: promoting educational actions on prudent prescribing directed to prescribers; incorporating computerized alert systems into clinical practice; implementing the use of tools for guiding medication prescribing; and, encouraging patient care by a multidisciplinary team, with the participation of a pharmacist. - These options can be incorporated into health systems either alone or together, and for that, it is necessary that the context be considered. - Aiming to inform decision makers, we included considerations on the implementation of these options regarding upper-middle income countries, like the Brazilian, and we also present considerations regarding equity.

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Section: Policy Options For Preventing or Reducing Prescribing Errorsmentioning

confidence: 99%

How to Prevent or Reduce Prescribing Errors: An Evidence Brief for Policy

et al. 2019

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“…However, outpatient antibiotic use is a significant driver of resistance, and antibiotic consumption per capita in the retail sector in India increased by approximately 22% between 2008 to 2016 ( Farooqui et al, 2018 ). Despite this, there are few evidence-based interventions to address antimicrobial misuse in primary healthcare or outpatient settings in LMICs ( Brinkmann et al, 2020 ; Ivanovska et al, 2013 ; Senn et al, 2014 ; Bhavnani et al, 2007 ; Gautham and Shyamprasad, 2010 ).…”

Section: Introductionmentioning

confidence: 99%

Perceptions of effective policy interventions and strategies to address antibiotic misuse within primary healthcare in India: A qualitative study

Nair

Engel

Zeegers

et al. 2023

Journal of Infection Prevention

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Objectives Antimicrobial resistance poses a major public health threat. Despite Indian retail sector antibiotic consumption per capita increasing by approximately 22% between 2008 and 2016, empirical studies that examine policy or behavioural interventions addressing antibiotic misuse in primary healthcare are scarce. Our study aimed to assess perceptions of interventions and gaps in policy and practice with respect to outpatient antibiotic misuse in India. Methods We conducted 23 semi-structured, in-depth interviews with a variety of key informants with diverse backgrounds in academia, non-government organisations, policy, advocacy, pharmacy, medicine and others. Data were charted into a framework matrix and analysed using a hybrid, inductive and deductive thematic analysis. Themes were analysed and organised according to the socio-ecological model at various levels ranging from the individual to the enabling environment. Results Key informants largely focused on the importance of adopting a structural perspective to addressing socio-ecological drivers of antibiotic misuse. There was a recognition that educational interventions targeting individual or interpersonal interactions were largely ineffective, and policy interventions should incorporate behavioural nudge interventions, improve the healthcare infrastructure and embrace task shifting to rectify staffing disparities in rural areas. Conclusions Prescription behaviour is perceived to be governed by structural issues of access and limitations in public health infrastructure that create an enabling environment for antibiotic overuse. Interventions should move beyond a clinical and individual focus on behaviour change with respect to antimicrobial resistance and aim for structural alignment between existing disease specific programs and between the informal and formal sector of healthcare delivery in India.

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Knowledge, Attitude, And Practice Towards Antibiotic Resistance Among General Practitioners in Polyclinics in Yerevan, Armenia

2021

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Aim: The objectives of the study were measuring knowledge, attitude, and practice scores among general practitioners on antibiotic resistance; exploring associations between antibiotics prescribing practice score among general practitioners and their knowledge and attitude scores after adjusting for other factors; and identifying barriers for rational antibiotics prescription by general practitioners. Methods: A cross-sectional study design was used. A self-administered survey was conducted among general practitioners employed in private and public polyclinics in Yerevan, Armenia. All general practitioners, working in Yerevan polyclinics and fluent in the Armenian language, were eligible for the study. The study was conducted in primary healthcare facilities of Yerevan, Armenia. All polyclinics (n=18) serving 30,000 or more populations were included in the study. All general practitioners available in selected polyclinics at the time of the survey were invited to take part in the survey, to target 20 general practitioners from each polyclinic. Results: Overall, 291 general practitioners participated in the study. Knowledge, attitude, and practice mean percent scores were 58.3%, 67.5%, and 63.0%, respectively. In the adjusted analysis, the practice percent score was significantly associated with the attitude percent score, though the relationship between the practice and knowledge scores was insignificant. The main barriers reported by general practitioners: lack of rapid diagnostic tests, high costs of laboratory tests, high costs of some antibiotics, and lack of guidelines. Conclusion: Identified low knowledge, attitude, and practice mean percent scores suggest a need for improvements in these areas. Availability of rapid and inexpensive diagnostic tests, enforcement of prescriptions could potentially prevent the development of antibiotic resistance. Keywords: drug resistance, general practitioners, polyclinics, prescribing

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

Cited by 4 publications

References 31 publications

How to Prevent or Reduce Prescribing Errors: An Evidence Brief for Policy

How to Prevent or Reduce Prescribing Errors: An Evidence Brief for Policy

Perceptions of effective policy interventions and strategies to address antibiotic misuse within primary healthcare in India: A qualitative study

Knowledge, Attitude, And Practice Towards Antibiotic Resistance Among General Practitioners in Polyclinics in Yerevan, Armenia

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