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Evaluation of prescription review and feedback policy on rational antibiotic use in primary healthcare settings in Beijing, China: a qualitative study using the Theoretical Domains Framework and the behaviour change wheel

OBJECTIVES: To decelerate antibiotic resistance driven by inappropriate antibiotic prescribing, a prescription review and feedback (PRF) policy is implemented in primary healthcare institutions (PHIs) in Beijing, China. However, evaluation of PRF implementation in PHIs is scarce. This study aims to...

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Autores principales: Wushouer, Haishaerjiang, Du, Kexin, Chen, Shicai, Li, Huangqianyu, Zhang, Wanmeng, Yang, Yaoyao, Hu, Lin, Zhou, Yue, Sun, Hui, Zheng, Bo, Guan, Xiaodong, Shi, Luwen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691747/
https://www.ncbi.nlm.nih.gov/pubmed/38046566
http://dx.doi.org/10.1093/jacamr/dlad128
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author Wushouer, Haishaerjiang
Du, Kexin
Chen, Shicai
Li, Huangqianyu
Zhang, Wanmeng
Yang, Yaoyao
Hu, Lin
Zhou, Yue
Sun, Hui
Zheng, Bo
Guan, Xiaodong
Shi, Luwen
author_facet Wushouer, Haishaerjiang
Du, Kexin
Chen, Shicai
Li, Huangqianyu
Zhang, Wanmeng
Yang, Yaoyao
Hu, Lin
Zhou, Yue
Sun, Hui
Zheng, Bo
Guan, Xiaodong
Shi, Luwen
author_sort Wushouer, Haishaerjiang
collection PubMed
description OBJECTIVES: To decelerate antibiotic resistance driven by inappropriate antibiotic prescribing, a prescription review and feedback (PRF) policy is implemented in primary healthcare institutions (PHIs) in Beijing, China. However, evaluation of PRF implementation in PHIs is scarce. This study aims to systematically identify the barriers and facilitators of PRF policy implementation to provide evidence for antimicrobial stewardship. METHODS: We conducted key informant interviews with 40 stakeholders engaged in the implementation of PRF in Beijing, including physicians, pharmacists and administrators. Interviews were audio recorded and transcribed verbatim. We coded the interview transcripts and mapped informant views to domains of the Theoretical Domains Framework. We then used a behaviour change wheel to suggest possible behavioural interventions. RESULTS: Procedural knowledge (Knowledge) and skills (Skill) of PRF were possessed by stakeholders. They felt responsible to promote the appropriate use of antibiotics (Social/professional role and identity) and believed that PRF could help to change inappropriate provider behaviours (Behavioural regulation) in prescribing antibiotics (Beliefs about consequences) under increased intention on antibiotic use (Stages of change). Moreover, informants called for a more unified review standard to enhance PRF implementation (Goals). Frequently identified barriers to PRF included inadequate capacity (Skill), using punishment mechanism (Behaviour regulation), reaching consistently lower antibiotic prescription rates (Goals), lack of resources (Environmental context and resources) and perceived pressure coming from patients (Social influences). CONCLUSIONS: Stakeholders believed that PRF implementation promoted the rational use of antibiotics at PHIs in Beijing. Still, PRF was hampered by inconsistencies in review process and resources needed for PRF implementation.
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spelling pubmed-106917472023-12-02 Evaluation of prescription review and feedback policy on rational antibiotic use in primary healthcare settings in Beijing, China: a qualitative study using the Theoretical Domains Framework and the behaviour change wheel Wushouer, Haishaerjiang Du, Kexin Chen, Shicai Li, Huangqianyu Zhang, Wanmeng Yang, Yaoyao Hu, Lin Zhou, Yue Sun, Hui Zheng, Bo Guan, Xiaodong Shi, Luwen JAC Antimicrob Resist Original Article OBJECTIVES: To decelerate antibiotic resistance driven by inappropriate antibiotic prescribing, a prescription review and feedback (PRF) policy is implemented in primary healthcare institutions (PHIs) in Beijing, China. However, evaluation of PRF implementation in PHIs is scarce. This study aims to systematically identify the barriers and facilitators of PRF policy implementation to provide evidence for antimicrobial stewardship. METHODS: We conducted key informant interviews with 40 stakeholders engaged in the implementation of PRF in Beijing, including physicians, pharmacists and administrators. Interviews were audio recorded and transcribed verbatim. We coded the interview transcripts and mapped informant views to domains of the Theoretical Domains Framework. We then used a behaviour change wheel to suggest possible behavioural interventions. RESULTS: Procedural knowledge (Knowledge) and skills (Skill) of PRF were possessed by stakeholders. They felt responsible to promote the appropriate use of antibiotics (Social/professional role and identity) and believed that PRF could help to change inappropriate provider behaviours (Behavioural regulation) in prescribing antibiotics (Beliefs about consequences) under increased intention on antibiotic use (Stages of change). Moreover, informants called for a more unified review standard to enhance PRF implementation (Goals). Frequently identified barriers to PRF included inadequate capacity (Skill), using punishment mechanism (Behaviour regulation), reaching consistently lower antibiotic prescription rates (Goals), lack of resources (Environmental context and resources) and perceived pressure coming from patients (Social influences). CONCLUSIONS: Stakeholders believed that PRF implementation promoted the rational use of antibiotics at PHIs in Beijing. Still, PRF was hampered by inconsistencies in review process and resources needed for PRF implementation. Oxford University Press 2023-12-01 /pmc/articles/PMC10691747/ /pubmed/38046566 http://dx.doi.org/10.1093/jacamr/dlad128 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Wushouer, Haishaerjiang
Du, Kexin
Chen, Shicai
Li, Huangqianyu
Zhang, Wanmeng
Yang, Yaoyao
Hu, Lin
Zhou, Yue
Sun, Hui
Zheng, Bo
Guan, Xiaodong
Shi, Luwen
Evaluation of prescription review and feedback policy on rational antibiotic use in primary healthcare settings in Beijing, China: a qualitative study using the Theoretical Domains Framework and the behaviour change wheel
title Evaluation of prescription review and feedback policy on rational antibiotic use in primary healthcare settings in Beijing, China: a qualitative study using the Theoretical Domains Framework and the behaviour change wheel
title_full Evaluation of prescription review and feedback policy on rational antibiotic use in primary healthcare settings in Beijing, China: a qualitative study using the Theoretical Domains Framework and the behaviour change wheel
title_fullStr Evaluation of prescription review and feedback policy on rational antibiotic use in primary healthcare settings in Beijing, China: a qualitative study using the Theoretical Domains Framework and the behaviour change wheel
title_full_unstemmed Evaluation of prescription review and feedback policy on rational antibiotic use in primary healthcare settings in Beijing, China: a qualitative study using the Theoretical Domains Framework and the behaviour change wheel
title_short Evaluation of prescription review and feedback policy on rational antibiotic use in primary healthcare settings in Beijing, China: a qualitative study using the Theoretical Domains Framework and the behaviour change wheel
title_sort evaluation of prescription review and feedback policy on rational antibiotic use in primary healthcare settings in beijing, china: a qualitative study using the theoretical domains framework and the behaviour change wheel
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691747/
https://www.ncbi.nlm.nih.gov/pubmed/38046566
http://dx.doi.org/10.1093/jacamr/dlad128
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