Factors influencing physicians’ antimicrobial prescribing decisions: A systematic review of qualitative studies

Inappropriate and overuse of antimicrobials is increasing antimicrobial resistance. Understanding physicians' antimicrobial decision‐making is essential for developing interventions to optimize prescribing. The aim of this review was to identify the factors that influence physicians' antim...

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Vydané v:British journal of clinical pharmacology Ročník 91; číslo 5; s. 1330 - 1351
Hlavní autori: Reali, Savannah, Kwang, Yee Chin, Cho, Jin‐Gun, Alffenaar, Jan‐Willem, Aslani, Parisa
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: England John Wiley and Sons Inc 01.05.2025
Predmet:
Anti-Bacterial Agents - therapeutic use
Anti-Infective Agents - therapeutic use
antimicrobial
antimicrobial resistance
Attitude of Health Personnel
Clinical Decision-Making
Decision Making
Humans
Inappropriate Prescribing - prevention & control
Physicians - psychology
Practice Guidelines as Topic
Practice Patterns, Physicians' - standards
Practice Patterns, Physicians' - statistics & numerical data
prescribing behaviour
qualitative
Qualitative Research
Review
systematic review
antimicrobial
clinical decision making
prescribing behaviour
systematic review
antimicrobial resistance
qualitative
ISSN:0306-5251, 1365-2125, 1365-2125
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Popis
Shrnutí:Inappropriate and overuse of antimicrobials is increasing antimicrobial resistance. Understanding physicians' antimicrobial decision‐making is essential for developing interventions to optimize prescribing. The aim of this review was to identify the factors that influence physicians' antimicrobial prescribing decisions. A systematic literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Embase, Medline and Scopus were searched from 2014 onwards using three key concepts: antimicrobial, prescribing and attitude. The search identified 11 038 articles for review. Studies were included if they used qualitative methods and obtained data directly from physicians. Factors influencing antimicrobial prescribing were extracted and categorized into physician‐related, patient‐related, medication‐ and condition‐related, and external factors. A model of the antimicrobial prescribing process was created to illustrate how these factors influence decision‐making. Fifty‐three articles from 23 countries met the inclusion criteria. Forty factors influencing antimicrobial prescribing were identified, with the most common being time pressures, patient/carer demand for antimicrobials, diagnostic uncertainty, clinical experience, and the use of evidence‐based guidelines and diagnostic tests. The harm to the patient and the physician of underprescribing were considered to outweigh the potential population harm of antimicrobial resistance due to overprescribing. Antimicrobial decision making is a complex process influenced by many different types of factors at each point in the prescribing journey. Awareness of these factors is vital for the success of interventions aiming to optimize antimicrobial prescribing. Future interventions should investigate how to balance individual and population harm whilst considering the individual factors that influence prescribing decisions.
Bibliografia:Funding information
This research did not receive any specific grant from funding agencies in the public, commercial or not‐for‐profit sectors.
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Funding information This research did not receive any specific grant from funding agencies in the public, commercial or not‐for‐profit sectors.
ISSN:0306-5251
1365-2125
1365-2125
DOI:10.1002/bcp.70011