Barriers and facilitators to guideline for the management of pediatric off-label use of drugs in China: a qualitative descriptive study

作者全名："Meng, Min; Hu, Jiale; Liu, Xiao; Tian, Min; Lei, Wenjuan; Liu, Enmei; Han, Zhu; Li, Qiu; Chen, Yaolong"

作者地址："[Meng, Min; Chen, Yaolong] Chongqing Med Univ, Chevidence Lab Child & Adolescent Hlth, Childrens Hosp, Chongqing, Peoples R China; [Meng, Min; Liu, Enmei; Li, Qiu; Chen, Yaolong] Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Key Lab Child Dev & Disorders, Int Sci & Technol Cooperat Base Child Dev & Crit D, Chongqing, Peoples R China; [Meng, Min; Liu, Enmei; Li, Qiu; Chen, Yaolong] Chongqing Key Lab Pediat, Chongqing, Peoples R China; [Meng, Min; Tian, Min; Lei, Wenjuan] Gansu Prov Hosp, Dept Pharm, Lanzhou, Peoples R China; [Hu, Jiale] Virginia Commonwealth Univ, Dept Nurse Anesthesia, Richmond, VA USA; [Liu, Xiao] Lanzhou Univ, Sch Publ Hlth, Lanzhou, Peoples R China; [Han, Zhu] Gansu Univ Chinese Med, Coll Pharm, Lanzhou, Peoples R China; [Li, Qiu] Chongqing Med Univ, Childrens Hosp, Dept Nephrol, Chongqing, Peoples R China; [Chen, Yaolong] Lanzhou Univ, Chinese Acad Med Sci 2021RU017, Sch Basic Med Sci, Res Unit Evidence Based Evaluat & Guidelines, Lanzhou, Peoples R China; [Chen, Yaolong] WHO Collaborating Ctr Guideline Implementat & Kno, Lanzhou, Peoples R China; [Chen, Yaolong] Lanzhou Univ, Grade Ctr, Lanzhou, Peoples R China"

通信作者："Chen, YL (通讯作者)，Chongqing Med Univ, Chevidence Lab Child & Adolescent Hlth, Childrens Hosp, Chongqing, Peoples R China.; Li, Q; Chen, YL (通讯作者)，Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Key Lab Child Dev & Disorders, Int Sci & Technol Cooperat Base Child Dev & Crit D, Chongqing, Peoples R China.; Li, Q; Chen, YL (通讯作者)，Chongqing Key Lab Pediat, Chongqing, Peoples R China.; Li, Q (通讯作者)，Chongqing Med Univ, Childrens Hosp, Dept Nephrol, Chongqing, Peoples R China.; Chen, YL (通讯作者)，Lanzhou Univ, Chinese Acad Med Sci 2021RU017, Sch Basic Med Sci, Res Unit Evidence Based Evaluat & Guidelines, Lanzhou, Peoples R China.; Chen, YL (通讯作者)，WHO Collaborating Ctr Guideline Implementat & Kno, Lanzhou, Peoples R China.; Chen, YL (通讯作者)，Lanzhou Univ, Grade Ctr, Lanzhou, Peoples R China."

来源：BMC HEALTH SERVICES RESEARCH

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001197811400003

JCR分区：Q2

影响因子：2.7

年份：2024

卷号：24

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Pediatric; Off-label use; Qualitative research; Implementation science; China

摘要："Background Despite being a global public health concern, there is a research gap in analyzing implementation strategies for managing off-label drug use in children. This study aims to understand professional health managers' perspectives on implementing the Guideline in hospitals and determine the Guideline's implementation facilitators and barriers.Methods Pediatric directors, pharmacy directors, and medical department directors from secondary and tertiary hospitals across the country were recruited for online interviews. The interviews were performed between June 27 and August 25, 2022. The Consolidated Framework for Implementation Research (CFIR) was adopted for data collection, data analysis, and findings interpretation to implement interventions across healthcare settings.Results Individual interviews were conducted with 28 healthcare professionals from all over the Chinese mainland. Key stakeholders in implementing the Guideline for the Management of Pediatric Off-Label Use of Drugs in China (2021) were interviewed to identify 57 influencing factors, including 27 facilitators, 29 barriers, and one neutral factor, based on the CFIR framework. The study revealed the complexity of the factors influencing managing children's off-label medication use. A lack of policy incentives was the key obstacle in external settings. The communication barrier between pharmacists and physicians was the most critical internal barrier.Conclusion To our knowledge, this study significantly reduces the implementation gap in managing children's off-label drug use. We provided a reference for the standardized management of children's off-label use of drugs."

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