美国牙科抗生素处方指南一致性的障碍和促进因素:国家牙科 PBRN 的定性研究。

IF 1.8 4区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Journal of public health dentistry Pub Date : 2024-04-01 DOI:10.1111/jphd.12611
Swetha Ramanathan PhD, MPH, Connie Yan PharmD, PhD, Katie J. Suda PharmD, MS, FCCP, Charlesnika T. Evans PhD, MPH, Tumader Khouja BDS, MPH, PhD, Ronald C. Hershow MD, Susan A. Rowan DDS, MS, Alan E. Gross PharmD, Lisa K. Sharp BSN, MA, PhD, National Dental PBRN Collaborative Group
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引用次数: 0

摘要

目的:虽然以前已经描述过导致牙科抗生素处方过多的因素,但以前的工作缺乏任何可指导未来干预发展的行为改变理论框架。本研究的目的是使用一个基于证据的概念模型来确定牙科医生适当开具抗生素处方的障碍和促进因素,作为未来旨在改变抗生素处方的干预措施的指南:对全国牙科实践研究网络(PBRN)的牙医进行了半结构式访谈,探讨影响抗生素处方的患者和实践因素。电话访谈录音由三位研究人员进行转录和独立编码。围绕 COM-B 模型对主题进行了整理,以便为前瞻性干预措施提供依据:104 名牙医中有 73 名(70.1%)接受了访谈。大多数是普通牙医(86.3%)、男性(65.7%)和白人(69.9%)。编码确定了支持牙科医生适当开具牙科抗生素处方的三大目标:(1)提高指南的可见性和可及性;(2)在没有明确指南的牙科情况下,为抗生素处方提供额外指导;以及(3)教育和沟通技能建设,重点是与患者和医生讨论抗生素的适当使用:我们的研究结果与其他关注牙科医生抗生素处方行为的研究结果一致。有必要了解牙科抗生素处方的促进因素和障碍,以便采取有针对性的干预措施,改善抗生素的合理处方。未来的干预措施应侧重于实施多模式策略,为牙科医生明智地开具抗生素处方提供必要的支持。
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Barriers and facilitators to guideline concordant dental antibiotic prescribing in the United States: A qualitative study of the National Dental PBRN

Objectives

While factors contributing to dental antibiotic overprescribing have previously been described, previous work has lacked any theoretical behavior change framework that could guide future intervention development. The purpose of this study was to use an evidence-based conceptual model to identify barriers and facilitators of appropriate antibiotic prescribing by dentists as a guide for future interventions aimed at modifying antibiotic prescribing.

Methods

Semi-structured interviews were conducted with dentists from the National Dental Practice Based Research Network (PBRN) exploring patient and practice factors perceived to impact antibiotic prescribing. Audio-recorded telephone interviews were transcribed and independently coded by three researchers. Themes were organized around the COM-B model to inform prospective interventions.

Results

73 of 104 dentists (70.1%) were interviewed. Most were general dentists (86.3%), male (65.7%), and white (69.9%). Coding identified three broad targets to support appropriate dental antibiotic prescribing among dentists: (1) increasing visibility and accessibility of guidelines, (2) providing additional guidance on antibiotic prescribing in dental scenarios without clear guidelines, and (3) education and communication skills-building focused on discussing appropriate antibiotic use with patients and physicians.

Conclusions

The findings from our study are consistent with other studies focusing on antibiotic prescribing behavior in dentists. Understanding facilitators and barriers to dental antibiotic prescribing is necessary to inform targeted interventions to improve appropriate antibiotic prescribing. Future interventions should focus on implementing multimodal strategies to provide the necessary support for dentists to judiciously prescribe antibiotics.

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来源期刊
Journal of public health dentistry
Journal of public health dentistry 医学-公共卫生、环境卫生与职业卫生
CiteScore
3.80
自引率
4.30%
发文量
69
审稿时长
6-12 weeks
期刊介绍: The Journal of Public Health Dentistry is devoted to the advancement of public health dentistry through the exploration of related research, practice, and policy developments. Three main types of articles are published: original research articles that provide a significant contribution to knowledge in the breadth of dental public health, including oral epidemiology, dental health services, the behavioral sciences, and the public health practice areas of assessment, policy development, and assurance; methods articles that report the development and testing of new approaches to research design, data collection and analysis, or the delivery of public health services; and review articles that synthesize previous research in the discipline and provide guidance to others conducting research as well as to policy makers, managers, and other dental public health practitioners.
期刊最新文献
Issue Information Associations between disability type and untreated dental decay among community dwelling US adults Evaluating the harmonization potential of oral health-related questionnaires in national longitudinal birth and child cohort surveys Educating long-term care staff on older adult oral health: Maine's oral team-based initiative vital access to education (MOTIVATE) program Integration of dental therapists in safety net practice increases access to oral health care in Minnesota
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