Antibiotic deprescribing: Spanish general practitioners' views on a new strategy to reduce inappropriate use of antibiotics in primary care.

IF 2.3 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL European Journal of General Practice Pub Date : 2022-12-01 DOI:10.1080/13814788.2022.2130887
Carl Llor, Gloria Cordoba, Sandi Michele de Oliveira, Lars Bjerrum, Ana Moragas
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Abstract

Background: A doctor may recommend that a patient stop an antibiotic course before its scheduled completion time if further treatment may cause more harm than benefit.

Objectives: This study explores general practitioners' (GP) opinions about the use of antibiotic deprescribing (AD) in general practice.

Methods: A cross-sectional, questionnaire-based study answered from February to March 2022. GPs (n = 6,083) affiliated with the largest Spanish scientific society of primary care were invited to participate. The survey included two statements related to use and fourteen views about AD rated by GPs using a 5-item Likert scale.

Results: Eleven hundred and seven doctors completed the surveys (18.2%), of whom 92.5% (95% confidence interval [CI] 90.8-94%) reported having used the AD strategy in their practice at least once. GPs felt very confident in using a deprescribing strategy in patients with common cold and influenza (97.6% and 93.5%, respectively) but less with acute bronchitis (45.5%); 12.1% (95% CI, 10.2-14.2%) considered this practice harmful to patients. Respondents reported using AD more frequently when they initiated the antibiotic course (96.8%; 95% CI, 95.5-97.7) than when the treatment was initiated by another doctor (52.3%; 95% CI, 49.3-55.3%). However, doctors aged >60 years were more prone to use AD compared with younger colleagues (64.5% vs. 50%; p < 0.005).

Conclusion: The GPs in this study employ the strategy of AD. Nonetheless, essential differences lie in their views of the way the strategy is used. Further studies are warranted to explore the beliefs behind these perceptions and promote wider use of AD by GPs.

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取消抗生素处方:西班牙全科医生对减少基层医疗机构抗生素不当使用新策略的看法。
背景:如果继续治疗可能弊大于利,医生可能会建议病人在抗生素疗程结束前停止治疗:如果继续治疗可能弊大于利,医生可能会建议患者在抗生素疗程结束前停止治疗:本研究探讨全科医生(GP)对在全科诊疗中使用抗生素停药(AD)的看法:方法:2022 年 2 月至 3 月进行的一项横断面问卷调查。隶属于西班牙最大的初级保健科学协会的全科医生(n = 6,083)应邀参加了调查。调查内容包括两份与使用相关的陈述和全科医生使用 5 项李克特量表评定的 14 种关于反式脂肪肝的观点:结果:117 名医生(18.2%)完成了调查,其中 92.5%(95% 置信区间 [CI] 90.8-94%)的医生表示在其临床实践中至少使用过一次 AD 策略。全科医生对在普通感冒和流感患者中使用去处方化策略非常有信心(分别为 97.6% 和 93.5%),但在急性支气管炎患者中则信心不足(45.5%);12.1%(95% 置信区间 [CI],10.2%-14.2%)的全科医生认为这种做法对患者有害。受访者表示,与其他医生(52.3%;95% CI,49.3-55.3%)相比,他们更常在自己开始抗生素疗程时使用 AD(96.8%;95% CI,95.5-97.7)。然而,与年轻医生相比,年龄大于 60 岁的医生更倾向于使用 AD(64.5% 对 50%;P 结论:本研究中的全科医生都采用了AD策略。然而,他们对使用该策略的看法存在本质区别。有必要开展进一步研究,探讨这些看法背后的信念,并促进全科医生更广泛地使用AD。
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来源期刊
European Journal of General Practice
European Journal of General Practice PRIMARY HEALTH CARE-MEDICINE, GENERAL & INTERNAL
CiteScore
5.10
自引率
5.90%
发文量
31
审稿时长
>12 weeks
期刊介绍: The EJGP aims to: foster scientific research in primary care medicine (family medicine, general practice) in Europe stimulate education and debate, relevant for the development of primary care medicine in Europe. Scope The EJGP publishes original research papers, review articles and clinical case reports on all aspects of primary care medicine (family medicine, general practice), providing new knowledge on medical decision-making, healthcare delivery, medical education, and research methodology. Areas covered include primary care epidemiology, prevention, diagnosis, pharmacotherapy, non-drug interventions, multi- and comorbidity, palliative care, shared decision making, inter-professional collaboration, quality and safety, training and teaching, and quantitative and qualitative research methods.
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