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Understanding how to improve physicians’ paradigms for prescribing antibiotics by using a conceptual design framework: a qualitative study
Stockholm University, Faculty of Social Sciences, Department of Computer and Systems Sciences.
Stockholm University, Faculty of Social Sciences, Department of Computer and Systems Sciences.
2018 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 18, article id 860Article in journal (Refereed) Published
Abstract [en]

Background: Antimicrobial resistance (AMR) is a growing public health threat. Primary care physicians are important inducers of the overuse of antimicrobials and inappropriate prescribing. Augmented reality (AR) might providea potential educational tool in health care. The aim of this study was to identify the need for education andexpectations for AR-based education in the context of improving the rational use of antibiotics by primarycare physicians in China.

Methods: The study used a qualitative approach based on face-to-face interviews with eleven physicians from three community health service centers and stations in China. We used a hybrid thematic analysis approach to analyze the interview data. A conceptual design framework, mobile augmented reality education (MARE), guided the work.

Results: The physicians’personal prescription paradigms included problems regarding the way they diagnosed and chose treatments and prescriptions. Although the physicians mentioned that they should not treat patients with antibiotics without proof of a bacterial infection, in practice, they often did not wait for necessary testresults before they prescribed antibiotics. It was also revealed that they often experienced difficulties when trying to convince patients to follow non-antibiotic treatments. Physicians’prescription of antibiotics was based on three different paths: if they thought there was a bacterial infection, if they thought preventing additional possible infections for the patient to be necessary; and if the patients requested antibiotics. The physicians expressed various learning needs for the rational use of antibiotics, and their expectations of an AR-based educational intervention included suggestions for contents, learning assets, learning environments and learning activities.

Conclusions: The results showed that the physicians were not only unfamiliar with national guidelines on the use of antibiotics and local AMR patterns but also had personal paradigm issues related to the physicians’decision making. Moreover, the physicians provided meaningful insights into and expectations for possible AR-based education on AMR. In this article, we demonstrate how to apply the MARE framework to analyze the needs of educational interventions for rational use of antibiotics.

Place, publisher, year, edition, pages
2018. Vol. 18, article id 860
Keywords [en]
Antimicrobial resistance, Primary care, Augmented reality, Continuing professional development
National Category
Information Systems
Research subject
Computer and Systems Sciences
Identifiers
URN: urn:nbn:se:su:diva-162343DOI: 10.1186/s12913-018-3657-xISI: 000450555400001OAI: oai:DiVA.org:su-162343DiVA, id: diva2:1265696
Available from: 2018-11-26 Created: 2018-11-26 Last updated: 2018-12-10Bibliographically approved

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