European Surveillance of Antimicrobial Consumption (ESAC): disease-specific quality indicators for outpatient antibiotic prescribing
European Surveillance of Antimicrobial Consumption (ESAC): disease-specific quality indicators for outpatient antibiotic prescribing
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DOI：
10.1136/bmjqs.2010.049049
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发表时间：
2011-09-01
影响因子：
5.4
通讯作者：
Goossens, Herman
中科院分区：
文献类型：
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作者：
Adriaenssens, Niels;Coenen, Samuel;Goossens, Herman
背景：2007年，ESAC（http：www.esac.ua.ac.be）发布了一套12个有效的欧洲门诊抗生素使用的药物特异性质量指标。在这项研究中，作者的目的是开发基于证据的疾病特异性质量指标门诊抗生素处方在European.Methods：召开了两次会议，以产生一个符合国际公认的建议，建立在一个类似的发展药物特异性质量指标，门诊抗生素处方的疾病特异性质量指标清单，并与CHAMP和快乐审计合作。62名专家被要求完成关于七个方面的拟议指标的两轮评分：其与（1）减少抗菌素耐药性，（2）患者健康益处，（3）成本效益，（4）政策制定者，（5）个体处方者，（6）其证据基础和（7）其可接受使用范围的相关性，使用范围从1（完全不同意）到9（完全同意）的量表。根据UCLA-RAND适当性方法对评分进行判断。结果：对于抗生素处方的6个主要适应症（急性中耳炎、急性上呼吸道感染、急性/慢性鼻窦炎、急性扁桃体炎、急性支气管炎/细支气管炎、膀胱炎/其他泌尿系感染）和肺炎，提出了3个质量指标，即处方的百分比（a）抗生素;（B）推荐的抗生素;（c）喹诺酮类。这一组由来自25个国家的40名专家评分。经过一轮评分，所有指标都已经被评为相关的所有尺寸，除了one.Conclusion：所有建议的疾病特异性质量指标门诊抗生素处方有表面效度，是潜在的适用。它们可以用来更好地描述抗生素的使用和评估门诊抗生素处方模式的质量。
Background: In 2007, ESAC (http://www.esac.ua.ac.be) published a set of 12 valid drug-specific quality indicators for outpatient antibiotic use in Europe. In this study, the authors aimed to develop evidence-based disease-specific quality indicators for outpatient antibiotic prescribing in Europe.Methods: Two meetings were convened to produce a list of disease-specific quality indicators for outpatient antibiotic prescribing which conform to internationally agreed recommendations, building on a similar development of drug-specific quality indicators, and in collaboration with CHAMP and HAPPY AUDIT. 62 experts were asked to complete two scoring rounds of the proposed indicators on seven dimensions: their relevance to (1) reducing antimicrobial resistance, (2) patient health benefit, (3) cost-effectiveness, (4) policy makers, (5) individual prescribers, (6) their evidence base and (7) their range of acceptable use, using a scale ranging from 1 (completely disagree) to 9 (completely agree). Scores were judged according to the UCLA-RAND appropriateness method.Results: For the six main indications for antibiotic prescribing (acute otitis media, acute upper-respiratory infection, acute/chronic sinusitis, acute tonsillitis, acute bronchitis/bronchiolitis, cystitis/other urinary infection) and for pneumonia, three quality indicators were proposed, the percentage prescribed (a) antibiotics; (b) recommended antibiotics; (c) quinolones. This set was scored by 40 experts from 25 countries. After one scoring round, all indicators were already rated as relevant on all dimensions, except one.Conclusion: All proposed disease-specific quality indicators for outpatient antibiotic prescribing have face validity and are potentially applicable. They could be used to better describe antibiotic use and assess the quality of antibiotic prescribing patterns in ambulatory care.