Factors Influencing the Adoption of Shared Decision Making for Antibiotic Treatments in Developing Countries: A Systematic Review of Physicians and Patients' Perspectives

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice Pub Date : 2025-09-21 DOI:10.1111/jep.70281

Gashaw Enbiyale Kasse, Suzanne M. Cosh, Judy Humphries, Md Shahidul Islam

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引用次数: 0

Abstract

Background

Shared decision-making is a decision-making process that involves both patients and their healthcare providers and can serve as a framework to reduce inappropriate antibiotic prescribing, thereby helping to control antibiotic resistance. However, little is known about the factors that influence the adoption of shared decision-making for antibiotic prescription in developing countries.

Objectives

The objective of this review is to identify factors influencing the adoption of shared decision-making for antibiotic prescription from both physicians' and patients' perspectives in developing countries.

Methods

We searched four electronic databases, Web of Science, Scopus, PubMed and ProQuest Health and Medicine, from 3 July 2023 to August 20, 2023. Studies were included if they assessed factors influencing the practice of shared decision-making during antibiotics prescription from physicians' or patients' perspectives in developing countries. The included studies were published in English and used quantitative, qualitative or mixed-method designs, spanning 2010 and 2023. The quality of the included articles was assessed using the Mixed Method Appraisal Tool (MMAT) version 2018, and data extraction from selected articles was performed by the first author and co-authors. Narrative synthesis was used to synthesis the qualitative result and incorporate quantitative data.

Results

Initially, a total of 2120 studies were identified. After evaluating the inclusion criteria, 24 were included in the final analysis. The main factors that influence the adoption of shared decision-making (SDM) in developing countries are time constraints, misunderstanding of shared decision-making, cultural and socioeconomic influence, power dynamics differences (hierarchical relationship between physicians and patients), patients' preference and agreement with shared decision-making, and availability of resources. Additionally, the quality of the relationship between patients and physicians plays a key role in influencing the practice of shared decision-making.

Conclusion

The findings highlight the importance of interventions aimed at both physicians and patients, such as education and training programs focused on shared decision-making for antibiotic prescription. However, further study is required to develop effective strategies that promote the adoption of shared decision-making practices while considering the contextual factors at play.

查看原文本刊更多论文

影响发展中国家抗生素治疗采用共同决策的因素：对医生和患者观点的系统回顾

共同决策是一个涉及患者及其医疗保健提供者的决策过程，可以作为减少不适当抗生素处方的框架，从而有助于控制抗生素耐药性。然而，对于影响发展中国家采用抗生素处方共同决策的因素知之甚少。本综述的目的是从发展中国家的医生和患者的角度确定影响抗生素处方共同决策的因素。方法检索Web of Science、Scopus、PubMed和ProQuest Health and Medicine 4个电子数据库，检索时间为2023年7月3日至2023年8月20日。如果研究从发展中国家医生或患者的角度评估影响抗生素处方共同决策实践的因素，则纳入研究。纳入的研究以英语发表，采用定量、定性或混合方法设计，时间跨度为2010年至2023年。使用混合方法评估工具（MMAT） 2018版对纳入文章的质量进行评估，并由第一作者和共同作者从所选文章中提取数据。采用叙事综合法对定性结果进行综合，并纳入定量数据。最初，共确定了2120项研究。经评估纳入标准后，24例纳入最终分析。影响发展中国家采用共同决策（SDM）的主要因素是时间限制、对共同决策的误解、文化和社会经济影响、权力动态差异（医生和患者之间的等级关系）、患者对共同决策的偏好和同意，以及资源的可用性。此外，患者和医生之间关系的质量在影响共同决策的实践中起着关键作用。研究结果强调了针对医生和患者的干预措施的重要性，例如关注抗生素处方共同决策的教育和培训计划。然而，需要进一步研究，以制定有效的战略，促进采用共同决策实践，同时考虑到环境因素的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.