A qualitative approach to examining antimicrobial prescribing in the outpatient dental setting.
A qualitative approach to examining antimicrobial prescribing in the outpatient dental setting.
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DOI：
10.1017/ash.2022.242
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Suda, Katie J
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作者：
Hughes, Ashley M;Evans, Charlesnika T;Fitzpatrick, Margaret A;Kale, Ibuola O;Vivo, Amanda;Boyer, Taylor L;Solanki, Pooja A;Gibson, Gretchen;Jurasic, M Marianne;Sharp, Lisa K;Echevarria, Kelly L;Suda, Katie J
了解门诊牙科循证抗生素处方的障碍和促进者。半结构化的面试。门诊牙科设置。来自全美40家退伍军人健康管理局(VA)机构的牙医。牙医是根据他们的处方模式确定的，并被招募参加关于对处方的看法的半结构化访谈。所有采访都被录音、转录和双重编码以供分析，编码员之间的可靠性很高。我们使用理论领域框架确定了一般趋势，并将主要主题映射到行为改变轮上，以确定改善循证处方的预期干预措施。总共有90名牙医参与了我们的研究。循证处方的以下障碍和促进者对牙医开抗生素的决策产生了影响：资源的获取、同行和其他护理提供者的社会影响、临床判断、对后果的信念、诊所环境的地方特征以及对能力的信念。这项工作的发现揭示了在牙科中提高对最新抗生素处方行为的认识的必要性，并可能为最佳的抗微生物管理干预提供信息，以支持牙医持续的专业发展和改善基于证据的处方。
To understand barriers and facilitators to evidence-based prescribing of antibiotics in the outpatient dental setting. Semistructured interviews. Outpatient dental setting. Dentists from 40 Veterans’ Health Administration (VA) facilities across the United States. Dentists were identified based on their prescribing patterns and were recruited to participate in a semistructured interview on perceptions toward prescribing. All interviews were recorded, transcribed, and double-coded for analysis, with high reliability between coders. We identified general trends using the theoretical domains framework and mapped overarching themes onto the behavior change wheel to identify prospective interventions that improve evidence-based prescribing. In total, 90 dentists participated in our study. The following barriers and facilitators to evidence-based prescribing emerged as impacts on a dentist’s decision making on prescribing an antibiotic: access to resources, social influence of peers and other care providers, clinical judgment, beliefs about consequences, local features of the clinic setting, and beliefs about capabilities. Findings from this work reveal the need to increase awareness of up-to-date antibiotic prescribing behaviors in dentistry and may inform the best antimicrobial stewardship interventions to support dentists’ ongoing professional development and improve evidence-based prescribing.