scholarly journals Knowledge, Attitudes and Intentions to Prescribe Antibiotics: A Structural Equation Modeling Study of Primary Care Institutions in Hubei, China

2019 ◽  
Vol 16 (13) ◽  
pp. 2385 ◽  
Author(s):  
Chenxi Liu ◽  
Chaojie Liu ◽  
Dan Wang ◽  
Xinping Zhang
Keyword(s):  
Primary Care ◽  
Antibiotic Resistance ◽  
Primary Care Physicians ◽  
Structural Equation ◽  
Antibiotic Use ◽  
Equation Modeling ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Motivation To Change ◽  
Attitudes And Practices

The aim of this paper is to measure the knowledge and attitudes of primary care physicians toward antibiotic prescriptions and their impacts on antibiotic prescribing. A questionnaire survey was conducted on 625 physicians from 67 primary care facilities in Hubei, China. Structural equation modelling (SEM) was applied to test the theoretical framework derived from the Knowledge, Attitudes, and Practices (KAP) theory. Physicians’ knowledge, five sub-types of attitudes, and three sub-types of behavioral intentions towards antibiotic use were measured. Physicians had limited knowledge about antibiotic prescriptions (average 54.55% correct answers to 11 questions). Although they were generally concerned about antibiotic resistance (mean = 1.28, SD = 0.43), and were reluctant to be submissive to pressures from consumer demands for antibiotics (mean = 1.29, SD = 0.65) and the requirements of defensive practice (mean = 1.11, SD = 0.63), there was a lack of motivation to change prescribing practices (mean = −0.29, SD = 0.70) and strong agreement that other stakeholders should take the responsibility (mean = −1.15, SD = 0.45). The SEM results showed that poor knowledge, unawareness of antibiotic resistance, and limited motivation to change contributed to physicians’ high antibiotics prescriptions (p < 0.001). To curb antibiotic over-prescriptions, improving knowledge itself is not enough. The lack of motivation of physicians to change needs to be addressed through a systematic approach.

scholarly journals Knowledge, attitudes and intentions to prescribe antibiotics: a structural equation modeling study of primary care institutions in Hubei, China

2019 ◽  
Author(s):  
Chenxi Liu ◽  
Chaojie Liu ◽  
Dan Wang ◽  
xinping zhang
Keyword(s):  
Primary Care ◽  
Antibiotic Resistance ◽  
Structural Equation ◽  
Equation Modeling ◽  
Upper Respiratory Tract ◽  
Prescribing Practices ◽  
Motivation To Change ◽  
Global Issues ◽  
Care Facilities ◽  
Tract Infections

Abstract Background Antibiotic resistance is one of the most serious global issues, in which physician's rational prescribing plays critical role. However, the determinants of physician's antibiotic use are still inconclusive, particularly in low- and middle income countries (LMICs). This study aimed to measure physician's knowledge and five important sub-attitudes toward antibiotic prescriptions and their impacts on prescribing. Methods A questionnaire survey was conducted on 625 physicians from 67 primary care facilities in Hubei of China. Structural equation modelling (SEM) was applied to test the theoretical framework derived from the theory of Knowledge, Attitudes and Practices (KAP). The attitudes (5 subscales) and behavioral intentions (3 subscales) were measured using a five-point Likert scale ranging from -2 to +2, with a negative score indicating disapproval and a positive score indicating approval of efforts for reducing antibiotic prescriptions. Results The study participants had a low level of knowledge about antibiotic prescriptions, giving an average of 54.55% correct answers to 11 questions. Although they were generally concerned about antibiotic resistance resulting from over-prescriptions (Mean of Ignorance=1.28, SD=0.43), and were reluctant to be submissive to pressures from consumer demands for antibiotics (Mean of Complacency=1.29, SD=0.65) and the requirements of defensive practice (Mean of Fear=1.11, SD=0.63), there was a lack of motivation to change prescribing practices (Mean of Indifference=-0.29, SD=0.70). In addition, there was strong agreement that other stakeholders should take the responsibility (Mean of Responsibility Avoidance=-1.15, SD=0.45). The SEM results showed that poor knowledge was a significant predictor (p<0.001) of high intentions to prescribe antibiotics for upper respiratory tract infections and a less positive attitude toward concerns about antibiotic resistance (ignorance) which was also associated with intentions to prescribe antibiotics. However, knowledge was not connected with the negative attitude toward motivation (indifference), a significant predictor (p<0.001) of intentions to refuse to reduce antibiotic prescriptions. Conclusion Physicians in primary care facilities in Hubei have low levels of knowledge about antibiotic prescriptions. But actions for improving knowledge by itself is not enough to curb over-prescriptions of antibiotics. The lack of motivation of physicians to change prescribing practices needs to be addressed through a systems approach.

scholarly journals 2071. A Survey of Antibiotic Prescribing Practices Among Adult Primary Care Physicians in Idaho

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S698-S698
Author(s):  
Anubhav Kanwar ◽  
Susan Heppler ◽  
Karl Madaras-Kelly ◽  
Martha Jaworski ◽  
Curtis Donskey
Keyword(s):  
Primary Care ◽  
Antimicrobial Stewardship ◽  
Primary Care Physicians ◽  
Healthcare Facility ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Prescription Data ◽  
Prescribing Practices ◽  
Diagnostic Uncertainty ◽  
Test Ordering

Abstract Background Prescribing an antibiotic is a complex process involving an interplay of prescriber’s knowledge, diagnostic acumen and patient factors. Understanding the prescriber rationale is key to provide feedback which might improve appropriateness of antibiotic prescribing. Currently, there are limited data on prescribing and test ordering practices among primary care physicians. Methods We surveyed primary care physicians taking care of adults (age 18 years and above). Physicians were contacted through the Idaho State Medical Board by a one-time email containing the survey link. The survey consisted of 25 questions under 2 major themes of diagnostic and antimicrobial stewardship (AS). It assessed physicians’ practice setting, ordering of diagnostic tests and antibiotics for common infections, delivery of patient education regarding antibiotics, availability of antibiogram and antimicrobial stewardship services, and assessment of penicillin allergy. Two infectious diseases physicians independently reviewed the results for appropriateness of testing and antibiotic prescribing per IDSA guidelines. Results Of 929 physicians surveyed, 157 (17%) responded. Of the respondents, 95 (61%) were male, the mean age was 50 years, and 72% worked in outpatient settings and were family medicine specialists. Only 55% of physicians reported having an AS program at their healthcare facility. Test-of-cure for C. difficile infection (24%) and UTI (13%) and use of superficial culture data to guide the treatment of osteomyelitis (27%) were the most common reasons for inappropriate testing. Longer than recommended duration, antibiotic combinations with overlap of spectrum, and guideline-discordant indications for prescribing antibiotics were the main reasons for inappropriate antibiotic use. The main factors influencing the decision to prescribe an antibiotic were diagnostic uncertainty (42%), being unsure of patient follow-up (23%) and cost of testing (21%). Conclusion The survey results highlight the need for prescriber education for decreasing inappropriate test ordering and antibiotic prescribing. Additional studies involving a review of patient records, lab and prescription data are needed to confirm these practices. Disclosures All authors: No reported disclosures.

scholarly journals Prescribers’ Knowledge, Attitudes and Behaviors on Antibiotics, Antibiotic Use and Antibiotic Resistance in Jordan

Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 858
Author(s):  
Reema A. Karasneh ◽  
Sayer I. Al-Azzam ◽  
Mera Ababneh ◽  
Ola Al-Azzeh ◽  
Ola B. Al-Batayneh ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Attitudes And Behaviors ◽  
And Behaviors ◽  
Ease Of Access

More research is needed on the drivers of irrational antibiotic prescribing among healthcare professionals and to ensure effective prescribing and an adequate understanding of the issue of antibiotic resistance. This study aimed at evaluating prescribers’ knowledge, attitudes and behaviors about antibiotic use and antibiotic resistance. A cross-sectional study was conducted utilizing an online questionnaire and included physicians and dentists from all sectors in Jordan. A total of 613 prescribers were included (physicians n = 409, dentists n = 204). Respondents’ knowledge on effective use, unnecessary use or associated side effects of antibiotics was high (>90%), compared with their knowledge on the spread of antibiotic resistance (62.2%). For ease of access to the required guidelines on managing infections, and to materials that advise on prudent antibiotic use and antibiotic resistance, prescribers agreed in 62% and 46.1% of cases, respectively. 28.4% of respondents had prescribed antibiotics when they would have preferred not to do so more than once a day or more than once a week. Among respondents who prescribed antibiotics, 63.4% would never or rarely give out resources on prudent use of antibiotics for infections. The findings are of importance to inform antibiotic stewardships about relevant interventions aimed at changing prescribers’ behaviors and improving antibiotic prescribing practices.

scholarly journals Young doctors’ perspectives on antibiotic use and resistance: a multinational and inter-specialty cross-sectional European Society of Clinical Microbiology and Infectious Diseases (ESCMID) survey

2019 ◽  
Vol 74 (12) ◽  
pp. 3611-3618 ◽  
Author(s):  
Bojana Beović ◽  
May Doušak ◽  
Céline Pulcini ◽  
Guillaume Béraud ◽  
Jose Ramon Paño Pardo ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Principal Component ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Self Assessment ◽  
Cross Sectional ◽  
Web Based ◽  
Five Dimensions ◽  
And Gender

Abstract Background Postgraduate training has the potential to shape the prescribing practices of young doctors. Objectives To investigate the practices, attitudes and beliefs on antibiotic use and resistance in young doctors of different specialties. Methods We performed an international web-based exploratory survey. Principal component analysis (PCA) and bivariate and multivariate [analysis of variance (ANOVA)] analyses were used to investigate differences between young doctors according to their country of specialization, specialty, year of training and gender. Results Of the 2366 participants from France, Greece, Italy, Portugal, Slovenia and Spain, 54.2% of young doctors prescribed antibiotics predominantly as instructed by a mentor. Associations between the variability of answers and the country of training were observed across most questions, followed by variability according to the specialty. Very few differences were associated with the year of training and gender. PCA revealed five dimensions of antibiotic prescribing culture: self-assessment of knowledge, consideration of side effects, perception of prescription patterns, consideration of patient sickness and perception of antibiotic resistance. Only the country of specialization (partial η2 0.010–0.111) and the type of specialization (0.013–0.032) had a significant effect on all five identified dimensions (P < 0.01). The strongest effects were observed on self-assessed knowledge and in the perception of antibiotic resistance. Conclusions The country of specialization followed by the type of specialization are the most important determinants of young doctors’ perspectives on antibiotic use and resistance. The inclusion of competencies in antibiotic use in all specialty curricula and international harmonization of training should be considered.

scholarly journals 2070. Assessing Primary Care Physicians’ Attitudes and Perceptions Toward Antibiotic Resistance and Outpatient Antibiotic Stewardship: A National Survey

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S698-S698
Author(s):  
Rachel M Zetts ◽  
Andrea Garcia ◽  
Jason Doctor ◽  
Jeffrey Gerber ◽  
Jeffrey A Linder ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
Antibiotic Resistance ◽  
National Survey ◽  
Antibiotic Stewardship ◽  
Primary Care Physicians ◽  
Antibiotic Use ◽  
The United States ◽  
Incentive Program ◽  
Data Feedback

Abstract Background At least 30% of outpatient antibiotic prescriptions are unnecessary. Outpatient antibiotic stewardship can improve prescribing and minimize the threat of antibiotic resistance. We assessed primary care physicians’ (PCPs) perceptions of antibiotic resistance, inappropriate antibiotic use, and the need for and impact of antibiotic stewardship activities. Methods We conducted a national survey of 1,550 internal and family medicine physicians and pediatricians recruited from a medical market research panel. Quotas were established to recruit participants by geographic region and specialty. For sample representativeness, survey weights were generated according to these characteristics using the American Medical Association’s Masterfile. Results Among respondents, 94% agreed that resistance is a problem in the United States, but only 55% felt it was a problem for their practice; 65% of respondents agreed they had seen an increase in resistant infections in their patients over the past 5 years. Responses about inappropriate antibiotic use were similar: 91% agreed that it was a problem, but 37% agreed that it is a problem in their practice. Additionally, 60% felt they prescribed antibiotics more appropriately than their peers. For antibiotic stewardship, 91% felt it was appropriate for office-based practices, but 53% believed that discussions with patients on the appropriate use of antibiotics is sufficient to address the problem. The majority of respondents indicated they were likely, very likely, or extremely likely to implement stewardship interventions in response to feedback or incentives from payers or health departments. The activities with the strongest likelihood to spur stewardship adoption included the state health department publishing local resistance patterns (82%), a payer creating a stand-alone incentive program for stewardship (80%), or a payer including it in a broader quality incentive program (76%). Conclusion PCPs feel that antibiotic resistance, inappropriate prescribing, and stewardship are important in the United States, but not for their own practices. This disconnect poses a challenge for the success of outpatient stewardship programs. Incentive or data feedback activities may help encourage stewardship uptake. Disclosures All authors: No reported disclosures.

scholarly journals Population-level Preferences for Primary Care Physicians' Characteristics in Japan: A Structural Equation Modeling

2010 ◽  
Vol 49 (2) ◽  
pp. 125-130 ◽  
Author(s):  
Osamu Takahashi ◽  
Sachiko Ohde ◽  
Joshua L. Jacobs ◽  
Yasuharu Tokuda ◽  
Haruo Yanai ◽  
...  
Keyword(s):  
Primary Care ◽  
Structural Equation Modeling ◽  
Primary Care Physicians ◽  
Structural Equation ◽  
Population Level ◽  
Equation Modeling

scholarly journals Identifying antibiotic prescribing patterns through multi-level latent profile analyses: a cross-sectional survey of primary care physicians in Hubei of China

2020 ◽  
Author(s):  
Dan Wang ◽  
Chaojie Liu ◽  
Xinping Zhang ◽  
Chenxi Liu
Keyword(s):  
Primary Care ◽  
Broad Spectrum ◽  
Primary Care Physicians ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Latent Profile Analyses ◽  
Broad Spectrum Antibiotics

Abstract Background Overuse of antibiotics significantly fuels the development of AMR, which threating the global population health. Great variations existed in antibiotic prescribing practices among physicians, indicating improvement potential for rational use of antibiotics. This study aims to identify antibiotic prescribing patterns of primary care physicians and potential determinants. Methods A cross-sectional survey was conducted on 551 physicians from 67 primary care facilities in Hubei selected through random cluster sampling, tapping into their knowledge, attitudes and prescribing practices toward antibiotics. Prescriptions (n=501,072) made by the participants from 1 January to 31 March 2018 were extracted from the medical records system. Seven indicators were calculated for each prescriber: average number of medicines per prescription, average number of antibiotics per prescription, percentage of prescriptions containing antibiotics, percentage of antibiotic prescriptions containing broad-spectrum antibiotics, percentage of antibiotic prescriptions containing parenteral administered antibiotics, percentage of antibiotic prescriptions containing restricted antibiotics, and percentage of antibiotic prescriptions containing antibiotics included in the WHO “Watch and Reserve” list. Two-level latent profile analyses were performed to identify the antibiotic prescribing patterns of physicians based on those indicators. Multi-nominal logistic regression models were established to identify determinants with the antibiotic prescribing patterns. Results On average, each primary care physician issued 909 (ranging from 100 to 11941 with a median of 474) prescriptions over the study period. The mean percentage of prescriptions containing antibiotics issued by the physicians reached 52.19% (SD=17.20%). Of those antibiotic prescriptions, an average of 82.29% (SD=15.83%) contained broad-spectrum antibiotics; 71.92% (SD=21.42%) contained parenteral administered antibiotics; 23.52% (SD=19.12%) contained antibiotics restricted by the regional government; and 67.74% (SD=20.98%) contained antibiotics listed in the WHO “Watch and Reserve” list. About 28.49% of the prescribers were identified as low antibiotic users, compared with 51.18% medium users and 20.33% high users. Higher use of antibiotics was associated with insufficient knowledge, indifference to changes, complacency with satisfied patients, low household income and rural location of the prescribers. Conclusion Great variation in antibiotic prescribing patterns exists among primary care physicians in Hubei of China. High use of antibiotics is not only associated with knowledge shortfalls but also low socioeconomic status of prescribers.

scholarly journals General practitioners’ knowledge, attitudes and practices on antibiotic prescribing for acute respiratory infections in children in Lubumbashi, Democratic Republic of Congo

2020 ◽  
Vol 4 (1) ◽  
pp. 011-017
Author(s):  
Wembonyama Kasongo Aubin Ndjadi ◽  
Mukuku Olivier ◽  
Kanteng Gray A-Wakamb ◽  
Shongo Mick Ya-Pongombo ◽  
Mutombo André Kabamba ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
General Practitioners ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Antibiotic Prescribing ◽  
Motivation To Change ◽  
Cross Sectional Survey ◽  
Republic Of Congo ◽  
Attitudes And Practices ◽  
Knowledge Attitudes And Practices

Objective: To assess the knowledge, attitudes and practices declared among general practitioners (GPs) concerning the use of antibiotics for the treatment of ARI in children under 5 years in Lubumbashi. Methods: A cross-sectional survey was conducted to assess the level of knowledge, attitude and practices concerning antibiotic prescribing among 67 GPs working in the pediatric setting in various health structures in Lubumbashi city, in the Democratic Republic of Congo. Data were collected from April 1st to June 30th, 2020. Results: GPs had limited knowledge about antibiotic prescriptions (mean of 46% correct answers to 8 questions). Although they are generally concerned about antibiotic resistance (mean ± SD = 0.50 ± 0.68), and are unwilling to submit to pressure to prescribe antibiotics to meet patient demands and expectations (mean ± SD = –1.78 ± 0.31) and the requirements to prescribe antibiotics for fear of losing patients (mean ± SD = –1.67 ± 0.47), there was a lack of motivation to change prescribing practices (mean ± SD = −0.37 ± 0.94) and strong agreement that they themselves should take responsibility for tackling antibiotic resistance (mean ± SD = 1.24 ± 0.74). Multiple linear regression results showed that higher knowledge scores were associated with less avoidance of responsibility when prescribing antibiotics (β = 0.919; p = 0.000). Conclusion: To curb the over-prescription of antibiotics, it is not enough to improve knowledge in itself. The lack of motivation of physicians to change must be addressed through a systematic approach. These data show the need for interventions that support the rational prescribing of antibiotics.

scholarly journals Medical and psychosocial factors associated with antibiotic prescribing in primary care: survey questionnaire and factor analysis

2017 ◽  
Vol 67 (656) ◽  
pp. e168-e177 ◽  
Author(s):  
Tau-Hong Lee ◽  
Joshua GX Wong ◽  
David CB Lye ◽  
Mark IC Chen ◽  
Victor WK Loh ◽  
...  
Keyword(s):  
Primary Care ◽  
Factor Analysis ◽  
Clinical Practice ◽  
Antibiotic Use ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Latent Factors ◽  
Factors Associated ◽  
Attitudes And Practices ◽  
Kap Survey

BackgroundAcute upper respiratory infections (AURI) are the leading causes of antibiotic prescribing in primary care although antibiotics are often not indicated.AimTo gain an understanding of the knowledge, attitudes, and practices (KAP) of GPs in Singapore and the associated latent factors to guide the implementation of an effective programme to reduce antibiotic use in primary care.Design and setting:An anonymous survey on the KAP of antibiotic use in AURI of GPs in Singapore.MethodKAP survey questionnaires were posted to all GPs from a database. To ascertain the latent factors affecting prescribing patterns, exploratory factor analysis was performed.ResultsAmong 427 responses, 351 (82.2%) were from GPs working in private practice. It was found that 58.4% of GPs in the private versus 72.4% of those in the public sector recognised that >80% of AURIs were caused by viruses (P = 0.02). The majority of GPs (353/427; 82.7%) felt that antibiotics were overprescribed in primary care. Significant factors associated with low antibiotic prescribing were good medical knowledge and clinical competency (adjusted odds ratio [aOR] 3.2, 95% confidence interval [CI] = 2.4 to 4.3), good clinical practice (aOR 2.7 [95% CI = 2.0 to 3.6]), availability of diagnostic tests (aOR 1.4 [95% CI = 1.1 to 1.8]), and desire to improve clinical practice (aOR 1.5 [95% CI = 1.2 to 1.9]). The conservative practice of giving antibiotics ‘to be on the safe side’ is significantly less likely to be associated with low antibiotic prescribing (aOR 0.7 [95% CI = 0.5 to 0.9]).ConclusionThis is the first KAP survey on antibiotic prescribing for AURI among GPs in Singapore. With the latent factors identified, future interventions should be directed at addressing these factors to reduce inappropriate antibiotic prescribing.

Sign in / Sign up

Export Citation Format

Share Document