TY - JOUR AU - Kyaw, bone Myint AU - Tudor Car, Lorainne AU - van Galen, Louise Sandra AU - van Agtmael, michel A AU - costeloe, cameire E AU - Ajuebor, Onyema AU - Campbell, James AU - Car, Josip PY - 2019 DA - 2019/09/12 TI -卫生专业抗生素管理数字化教育:数字健康教育合作的系统评价和荟萃分析JO - J Med Internet Res SP - e14984 VL - 21 IS - 9 KW -数字教育KW -抗生素管理KW -系统评价KW -荟萃分析KW -随机对照试验AB -背景:不适当的抗生素处方是抗生素耐药性的关键因素之一，需要通过包括教育在内的一系列干预措施进行管理。目的:我们旨在总结与传统教育相比，抗生素管理数字化教育在提高卫生保健专业人员的知识、技能、态度和临床实践方面的有效性的证据。方法:检索1990年1月1日至2018年9月20日期间发表的7个电子数据库和2个试验注册库的随机对照试验(rct)和聚类rct。没有语言限制。我们还检索了国际临床试验注册平台搜索门户和对照试验metareregister，以确定未发表的试验，并检查了纳入研究的参考文献列表和相关系统评价的研究资格。我们采用Cochrane方法选择研究，提取数据，评估和综合符合条件的研究。我们使用随机效应模型进行合并分析，并通过森林样地的目视检查和I2统计量的计算来评估统计异质性。结果:纳入6组随机对照试验和2组随机对照试验，共纳入655名初级保健实践、1392名初级保健医生和485,632名患者。干预措施包括个人数字助理; short text messages; online digital education including emails and websites; and online blended education, which used a combination of online digital education and traditional education materials. The control groups received traditional education. Six studies assessed postintervention change in clinical practice. The majority of the studies (4/6) reported greater reduction in antibiotic prescription or dispensing rate with digital education than with traditional education. Two studies showed significant differences in postintervention knowledge scores in favor of mobile education over traditional education (standardized mean difference=1.09, 95% CI 0.90-1.28; I2=0%; large effect size; 491 participants [2 studies]). The findings for health care professionals’ attitudes and patient-related outcomes were mixed or inconclusive. Three studies found digital education to be more cost-effective than traditional education. None of the included studies reported on skills, satisfaction, or potential adverse effects. Conclusions: Findings from studies deploying mobile or online modalities of digital education on antibiotic management were complementary and found to be more cost-effective than traditional education in improving clinical practice and postintervention knowledge, particularly in postregistration settings. There is a lack of evidence on the effectiveness of other digital education modalities such as virtual reality or serious games. Future studies should also include health care professionals working in settings other than primary care and low- and middle-income countries. Clinical Trial: PROSPERO CRD42018109742; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=109742 SN - 1438-8871 UR - //www.mybigtv.com/2019/9/e14984/ UR - https://doi.org/10.2196/14984 UR - http://www.ncbi.nlm.nih.gov/pubmed/31516125 DO - 10.2196/14984 ID - info:doi/10.2196/14984 ER -