Educational interventions to improve prescription and dispensing of antibiotics: a systematic review

BMC Public Health

Adolfo Figueiras⁴  Luiza Breitenfeld⁵  António Teixeira Rodrigues³  Sara Soares³  Maria Teresa Herdeiro¹  Fátima Roque² 

[1]CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, Rua Central de Gandra, 1317, 4585-116 Gandra, PRD, Portugal

[2]Research Unit for Inland Development, Polytechnic of Guarda (Unidade de Investigação para o Desenvolvimento do Interior – UDI/IPG), Av. Dr. Francisco Sá Carneiro n°50, 6300-559 Guarda, Portugal

[3]Centre for Cell Biology, University of Aveiro (Centro de Biologia Celular – CBC/UA)

[4] Campus Universitário de Santiago, 3810-193 Aveiro, Portugal

[5]Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública – CIBERESP), University of Santiago de Compostela, R/ de San Francisco, s/n 15782 Santiago de Compostela, Spain

[6]Health Sciences Research Centre, University of Beira Interior (Centro de Investigação em Ciências da Saúde – CICS/UBI), Av. Infante D. Henrique, 6200-506 Covilhã, Portugal

关键词: Education pharmacy continuing;    Education medical continuing;    Behavior change;    Review;    Drug resistance microbial;   

Others  :  1092293
DOI  :  10.1186/1471-2458-14-1276

 received in 2014-08-11, accepted in 2014-12-08,  发布年份 2014

【 摘 要 】

Background

Excessive and inappropriate antibiotic use contributes to growing antibiotic resistance, an important public-health problem. Strategies must be developed to improve antibiotic-prescribing. Our purpose is to review of educational programs aimed at improving antibiotic-prescribing by physicians and/or antibiotic-dispensing by pharmacists, in both primary-care and hospital settings.

Methods

We conducted a critical systematic search and review of the relevant literature on educational programs aimed at improving antibiotic prescribing and dispensing practice in primary-care and hospital settings, published in January 2001 through December 2011.

Results

We identified 78 studies for analysis, 47 in primary-care and 31 in hospital settings. The studies differed widely in design but mostly reported positive results. Outcomes measured in the reviewed studies were adherence to guidelines, total of antibiotics prescribed, or both, attitudes and behavior related to antibiotic prescribing and quality of pharmacy practice related to antibiotics. Twenty-nine studies (62%) in primary care and twenty-four (78%) in hospital setting reported positive results for all measured outcomes; fourteen studies (30%) in primary care and six (20%) in hospital setting reported positive results for some outcomes and results that were not statistically influenced by the intervention for others; only four studies in primary care and one study in hospital setting failed to report significant post-intervention improvements for all outcomes. Improvement in adherence to guidelines and decrease of total of antibiotics prescribed, after educational interventions, were observed, respectively, in 46% and 41% of all the reviewed studies. Changes in behaviour related to antibiotic-prescribing and improvement in quality of pharmacy practice was observed, respectively, in four studies and one study respectively.

Conclusion

The results show that antibiotic use could be improved by educational interventions, being mostly used multifaceted interventions.

【 授权许可】

   
2014 Roque et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

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