Behavioral Components and Context of Antimicrobial Prescription in a Tertiary Hospital in Portugal
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://hdl.handle.net/10216/154294 |
Resumo: | Consumption of antimicrobials is an important driver of antimicrobial resistance. There is limited knowledge of the key determinants of antimicrobial prescribing behavior in hospitals. An understanding of these determinants is required for the successful design, adoption, and implementation of quality improvement interventions in Antimicrobial Stewardship Programs (ASP). This study aimed to describe the main factors that influence the doctor's decision on antimicrobials prescribing and to identify the behaviors that drive physicians' decision making. A structured web-based questionnaire focused on behavioral components of antimicrobial prescription was applied to the medical staff of three different departments-Internal Medicine, General Surgery, and Intensive Care Medicine-of a university hospital. All doctors agreed that inadequate use of antimicrobials increases AMR. A total of 77% of the surgeons and 100% of the internists and intensivists perceived antimicrobial prescription as a priority in the department. Full autonomy in antimicrobial prescription was preferred by internists (64%) but not by surgeons (18%) and intensivists (24%). Most physicians were keen to have ASP advice, but most did not want advice from colleagues of the same service. Almost all surgeons ask for advice when prescribing, but only 68% of the internists do it. Less than half of all physicians and only 25% of the surgeons felt free to prescribe contrary to guidelines. Most physicians, particularly in Intensive Care Medicine (94%), adopt the wait and see strategy when no microbiologic confirmation is available, but 27% of the surgeons start empirical therapy. In conclusion, the context of antimicrobial prescription, autonomy, and confidence in antimicrobial prescription demonstrated heterogeneity between the three departments and this should be considered when planning ASP. |
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Behavioral Components and Context of Antimicrobial Prescription in a Tertiary Hospital in Portugalbehaviorantimicrobial prescriptionantimicrobial stewardshiptheory of planned behaviorConsumption of antimicrobials is an important driver of antimicrobial resistance. There is limited knowledge of the key determinants of antimicrobial prescribing behavior in hospitals. An understanding of these determinants is required for the successful design, adoption, and implementation of quality improvement interventions in Antimicrobial Stewardship Programs (ASP). This study aimed to describe the main factors that influence the doctor's decision on antimicrobials prescribing and to identify the behaviors that drive physicians' decision making. A structured web-based questionnaire focused on behavioral components of antimicrobial prescription was applied to the medical staff of three different departments-Internal Medicine, General Surgery, and Intensive Care Medicine-of a university hospital. All doctors agreed that inadequate use of antimicrobials increases AMR. A total of 77% of the surgeons and 100% of the internists and intensivists perceived antimicrobial prescription as a priority in the department. Full autonomy in antimicrobial prescription was preferred by internists (64%) but not by surgeons (18%) and intensivists (24%). Most physicians were keen to have ASP advice, but most did not want advice from colleagues of the same service. Almost all surgeons ask for advice when prescribing, but only 68% of the internists do it. Less than half of all physicians and only 25% of the surgeons felt free to prescribe contrary to guidelines. Most physicians, particularly in Intensive Care Medicine (94%), adopt the wait and see strategy when no microbiologic confirmation is available, but 27% of the surgeons start empirical therapy. In conclusion, the context of antimicrobial prescription, autonomy, and confidence in antimicrobial prescription demonstrated heterogeneity between the three departments and this should be considered when planning ASP.MDPI20232023-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/10216/154294eng2079-638210.3390/antibiotics12061032Almeida-Costa, APMPaiva, JAAlmeida, AJSBarbosa, ECorreia, Sinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-29T14:52:07Zoai:repositorio-aberto.up.pt:10216/154294Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T00:10:30.980612Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Behavioral Components and Context of Antimicrobial Prescription in a Tertiary Hospital in Portugal |
title |
Behavioral Components and Context of Antimicrobial Prescription in a Tertiary Hospital in Portugal |
spellingShingle |
Behavioral Components and Context of Antimicrobial Prescription in a Tertiary Hospital in Portugal Almeida-Costa, APM behavior antimicrobial prescription antimicrobial stewardship theory of planned behavior |
title_short |
Behavioral Components and Context of Antimicrobial Prescription in a Tertiary Hospital in Portugal |
title_full |
Behavioral Components and Context of Antimicrobial Prescription in a Tertiary Hospital in Portugal |
title_fullStr |
Behavioral Components and Context of Antimicrobial Prescription in a Tertiary Hospital in Portugal |
title_full_unstemmed |
Behavioral Components and Context of Antimicrobial Prescription in a Tertiary Hospital in Portugal |
title_sort |
Behavioral Components and Context of Antimicrobial Prescription in a Tertiary Hospital in Portugal |
author |
Almeida-Costa, APM |
author_facet |
Almeida-Costa, APM Paiva, JA Almeida, AJS Barbosa, E Correia, S |
author_role |
author |
author2 |
Paiva, JA Almeida, AJS Barbosa, E Correia, S |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Almeida-Costa, APM Paiva, JA Almeida, AJS Barbosa, E Correia, S |
dc.subject.por.fl_str_mv |
behavior antimicrobial prescription antimicrobial stewardship theory of planned behavior |
topic |
behavior antimicrobial prescription antimicrobial stewardship theory of planned behavior |
description |
Consumption of antimicrobials is an important driver of antimicrobial resistance. There is limited knowledge of the key determinants of antimicrobial prescribing behavior in hospitals. An understanding of these determinants is required for the successful design, adoption, and implementation of quality improvement interventions in Antimicrobial Stewardship Programs (ASP). This study aimed to describe the main factors that influence the doctor's decision on antimicrobials prescribing and to identify the behaviors that drive physicians' decision making. A structured web-based questionnaire focused on behavioral components of antimicrobial prescription was applied to the medical staff of three different departments-Internal Medicine, General Surgery, and Intensive Care Medicine-of a university hospital. All doctors agreed that inadequate use of antimicrobials increases AMR. A total of 77% of the surgeons and 100% of the internists and intensivists perceived antimicrobial prescription as a priority in the department. Full autonomy in antimicrobial prescription was preferred by internists (64%) but not by surgeons (18%) and intensivists (24%). Most physicians were keen to have ASP advice, but most did not want advice from colleagues of the same service. Almost all surgeons ask for advice when prescribing, but only 68% of the internists do it. Less than half of all physicians and only 25% of the surgeons felt free to prescribe contrary to guidelines. Most physicians, particularly in Intensive Care Medicine (94%), adopt the wait and see strategy when no microbiologic confirmation is available, but 27% of the surgeons start empirical therapy. In conclusion, the context of antimicrobial prescription, autonomy, and confidence in antimicrobial prescription demonstrated heterogeneity between the three departments and this should be considered when planning ASP. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023 2023-01-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://hdl.handle.net/10216/154294 |
url |
https://hdl.handle.net/10216/154294 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
2079-6382 10.3390/antibiotics12061032 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
MDPI |
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MDPI |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799136028546564097 |