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首页> 外文期刊>Patient Preference and Adherence >Determinants of initiation, implementation, and discontinuation of amoxicillin by adults with acute cough in primary care
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Determinants of initiation, implementation, and discontinuation of amoxicillin by adults with acute cough in primary care

机译：成人初级咳嗽中急性咳嗽阿莫西林开始，实施和终止的决定因素

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Aim: To investigate the determinants of adherence to amoxicillin in patients with acute lower respiratory tract infection. Materials and methods: Three European data sets were used. Adherence data were collected using self-reported diaries. Candidate determinants included factors relating to patient, condition, therapy, health care system/provider, and the study in which the patient participated. Logistic and Cox regression models were used to investigate the determinants of initiation, implementation, and discontinuation of amoxicillin. Results: Although initiation differed across samples, implementation and discontinuation were similar. Determinants of initiation were days waited before consulting, duration of prescription, and being in a country where a doctor-issued sick certificate is required for being off work for <7 days. Implementation was higher for older participants or those with abnormal auscultation. Implementation was lower for those prescribed longer courses of amoxicillin (≥8 days). Time from initiation to discontinuation was longer for longer prescriptions and shorter for those from countries where single-handed practices were widespread. Conclusion: Nonadherence to amoxicillin was largely driven by noninitiation. Differing sets of determinants were found for initiation, implementation, and discontinuation. There is a need to further understand the reasons for these determinants, the impact of poor adherence to antibiotics on outcomes, and to develop interventions to improve antibiotic use when prescribed.
机译：目的：探讨急性下呼吸道感染患者对阿莫西林依从性的决定因素。材料和方法：使用了三个欧洲数据集。使用自我报告的日记收集依从性数据。候选决定因素包括与患者，病情，治疗，医疗保健系统/提供者以及患者参加的研究有关的因素。使用Logistic和Cox回归模型研究阿莫西林启动，实施和终止的决定因素。结果：尽管起始时间因样品而异，但实施和终止均相似。决定启动的时间是咨询之前需要等待的天数，处方的持续时间以及所处的国家/地区，要求该医生签发病假证明才能下班少于7天。老年参与者或听诊异常的参与者的实施率更高。那些规定的阿莫西林疗程较长（≥8天）的患者的实施率较低。对于更长的处方，从开始到停药的时间更长，而对于单手操作广泛的国家，则从开始到停药的时间更长。结论：对阿莫西林的不依从性在很大程度上是由未引发引起的。发现了不同的行列式决定因素用于启动，实施和终止。有必要进一步了解这些决定因素的原因，对抗生素依从性差的后果的影响，并在制定处方时制定干预措施以改善抗生素的使用。

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