Addressing AMR and planetary health in primary care: the potential of general practitioners as change agents

被引:3
作者
Tigges, Paula [1 ]
Greser, Alexandra [2 ]
Gagyor, Ildiko [2 ]
Kraft, Judith [3 ]
Maun, Andy [4 ,5 ]
Schmiemann, Guido [6 ]
Schwienhorst-Stich, Eva-Maria [2 ,7 ]
Heintze, Christoph [1 ]
Schuster, Angela [1 ]
机构
[1] Charite Univ Med Berlin, Inst Gen Practice, Berlin, Germany
[2] Univ Hosp Wuerzburg, Dept Gen Practice, Wurzburg, Germany
[3] Charite Univ Med Berlin, Inst Biometry & Clin Epidemiol, Berlin, Germany
[4] Univ Freiburg, Inst Gen Practice Primary Care, Fac Med, Freiburg, Germany
[5] Univ Freiburg, Med Ctr, Freiburg, Germany
[6] Univ Bremen, Inst Publ Hlth & Nursing Res, Dept Hlth Serv Res, Bremen, Germany
[7] Univ Wurzburg, Fac Med, Working Grp Climate & Planetary Hlth, Wurzburg, Germany
关键词
planetary Health; antimicrobial resistance; primary care; change agents; general practice; ANTIMICROBIAL-RESISTANCE; MULTIMODAL INTERVENTION; SOCIOECONOMIC-STATUS; PERCEPTIONS; BEHAVIOR; ANTIBIOTICS; CLIMATE; PERSPECTIVE; CHALLENGES; DECISIONS;
D O I
10.3389/fpubh.2024.1383423
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Introduction Antimicrobial resistance is closely linked with the health and stability of environmental systems and therefore a challenge for the health of the planet. General Practitioners, owing to their trusted positions and close patient relationships, can play a crucial role in addressing antimicrobial resistance within the framework of Planetary Health. The goal of our study was to examine General Practitioners' knowledge, attitude, and practice regarding the linkage of antimicrobial resistance with Planetary Health to understand their potential as agents of change in this domain.Materials and methods We conducted 19 guided interviews with General Practitioners from four different German federal states (August-September 2022). Participants were selected from the intervention group of the RedAres randomized controlled trial, a study designed to optimize therapy and prescribing practices for uncomplicated urinary tract infections in general practice. Data were analyzed using Mayring's structured qualitative content analysis and the typology approach by Kelle and Kluge.Results General Practitioners generally demonstrated the ability to identify the interlinkages between antimicrobial resistance and Planetary Health. However, they exhibited varying levels of knowledge, problem awareness, and accountability for the associated challenges and partially outsourced the responsibility for Planetary Health. Some General Practitioners were capable of integrating Planetary Health arguments into patient counseling. They recognized rational prescribing practice, self-reflection on antimicrobial resistance and Planetary Health, interprofessional exchange, and raising awareness among patients as potential avenues for engagement in promoting Planetary Health.Discussion As antimicrobial resistance is increasingly recognized as a Planetary Health challenge, empowering General Practitioners as change agents requires tailored measures based on their level of previous knowledge and their attitude toward Planetary Health. General Practitioners express a need for concrete advice on how to integrate antimicrobial resistance as a Planetary Health topic into their daily activities. Developing and evaluating adaptable training materials is essential. Additionally, the integration of Planetary Health outcomes into clinical guidelines could accelerate the adoption of this dimension in antibiotic prescribing practices within primary care settings.
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页数:15
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