How I connect the dots from the bibliography

How individual make the decision on purchasing antibiotics?

Lin, L., Sun, R., Yao, T., Zhou, X. and Harbarth, S. (2020) ‘Factors influencing inappropriate use of antibiotics in outpatient and community settings in China: a mixed-methods systematic review’, BMJ global health, 5(11), pp. e003599.

In this article, authors aim to identify and evaluate the factors of inappropriate use of antibiotics in the Chinese environment, in order to promote the development of interventions to alleviate inappropriate consumption in the absence of clinical indications. In this article, it explain the inappropriate outpatient and community antibiotic use is influenced by non-biomedical factors at the individual, community, health system and societal levels in mainland China, contributing to a high antibiotic use rate. It also outline the reasons of individual chose to purchase the antibiotics from different levels, and it helps me to analysis the mindset and different context. I pretty agree the points that “multifaceted, interactive personal and environmental factors shape antibiotic use”, and “inappropriate antibiotic consumption is unlikely to decrease without multifaceted, context-tailored strategies targeting patients, prescribe and healthcare systems.” The findings and data in this article support me to analysis the personal behaviors and how the ecosystem influence the antibiotics using.

Liu, C., Liu, C., Wang, D., Deng, Z., Tang, Y. and Zhang, X. (2019b) ‘Determinants of antibiotic prescribing behaviors of primary care physicians in Hubei of China: a structural equation model based on the theory of planned behavior’, Antimicrobial Resistance & Infection Control, 8(1), pp. 1–8.

The article is mainly works on understanding how physicians prescribe antibiotics is increasingly highlighted for the purpose of promoting good practice. The article helps me to understand how to shape the antibiotic prescribing behaviors of physicians in primary care based on the theory of planned behavior. Based on this TPB model and interview with medical physicians, I can hand out the questionnaires for doctors and physicians to have understand the domain factors which lead to over-prescribe and how can they educate the patients about AMR. What’s more, through the exploration on physicians, I can identify the painpoints and opportunities about the healthcare system. What interests me the most from this article is that “Physicians may have varied understanding about rational use of antibiotics.” It reminds me of that the co-design and workshop would help the physicians and policy managers to have a common knowledge on what is “rational” use of antibiotics, and co-design what is proper prescription system for them.

Yin-qi L. , SUN Q. , YIN J. , Xue-ran X. , YAO L.(2019) ‘Policy evolution of antibiotic resistance governance in China and its implication’

The article is analysis on the policy development of antibiotics use in recent 30 years, the journey presents how the policy of AMR is gradually developed and how the policy is making a difference. Through this article, we can get the point of that the policy of AMR lack maneuverability, the lack of specific content of the antibiotic drug control, and the unbalanced city and county development make implementing the antibiotic resistance management policy challenging to achieve the ideal effect of control and governance. The article is also reminding me that the policy need to combine different sectors to co-design the policy to meet different needs and demands. To fit different context and requirements from higher level, we need to test and iterate to see whether the policy is working and suitable for the scenario.

Muhammad H. Z. (2020) ‘Biography of Resistance: The Epic Battle Between People and Pathogen’, Harper Wave

This book tells that in the battle between microbes and antibiotics, the emergence and development of microbial resistance has seriously threatened the health of all humankind. The general public’s understanding of microbial drug resistance remains at “too much intake of antibiotics will cause the human body to develop resistance, which prevents antibiotics from working, affects the cure of diseases, and even leads to death. Therefore, from the perspective of the entire system, The aquaculture industry that enters the human food chain should not use too many antibiotics.” Mohamed H. Zaman combed through the human discovery of microorganisms, the development of antibiotics, and the pathological and social factors that cause microbial resistance and presented The epic battle between people and pathogens. The exploration of drug resistance mechanisms is in the ascendant, but the resistance of pathogenic bacteria is becoming more and more intense. To better control antibiotic resistance, several countries have also established interconnected regulatory networks to track the latest discoveries of drug-resistant bacteria closely. In 2015, the WHO’s global action plan was launched to “can reverse the development trend of antibiotic resistance.” China was also awakened by the alarm and began to pay attention to the issue of antibiotics. This book helped me better understand the development of antibiotics and helped me sort out much correct knowledge. When I think about how to control antibiotic resistance, it is from the biological point of view of the resistance mechanism and the social point of view. Set out, think about the medical mechanism, social pressure, etc.

Macduff, C., Marie Rafferty, A., Prendiville, A., Currie, K., Castro-Sanchez, E., King, C., Carvalho, F. and Iedema, R. (2020) ‘Fostering nursing innovation to prevent and control antimicrobial resistance using approaches from the arts and humanities’, Journal of Research in Nursing, 25(3), pp. 189–207.

The article introduces the RIPEN projects research on how to use relevant approaches to nurses to re-envisage their infection control practice ecologies in response to antimicrobial resistance. The report also presents how they use the “lab” methodology to hold workshops on the research questions in two cities. A “policy lab” will be convened with the research team to finalize their policy design and last subsidiary question through the workshops. The article inspired me about how the workshops could build trust and understanding with nurses and other stakeholders. Through this, nurses and participants can quickly build empathy on understanding their daily routine with AMR. The article also inspired me how to define different stakeholders’ role in the system. I want to explore the pharmacist’s role in the primary healthcare system, and it’s diversity on AMR by using the storyboard and other approaches. I need to consider the tools I used in the workshops and interviews, like the visualization, to support building understanding and gain insights from observation. It is encouraging for me to tell combing the design approach. I can help different stakeholders see AMR in multi-dimension and help interdisciplinary sectors build an understanding of each other and co-design their ideal AMR plan and policy.



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