Problems related to antifungal prescription: a qualitative study of the views of intensivists.
OBJECTIVE
The choice of the appropriate antifungal medication is essential for therapeutic success. Although guidelines are available in the literature that regulate the consistent use of antifungal, no previous qualitative studies have addressed the difficulties related to the use of antifungal medication, especially in the intensive care unit (ICU). Our objective was to qualitatively investigate how intensivists consider antifungal prescriptions in an adult ICU.


METHODS
The Grounded Theory analytical method was used for the data analysis. Physicians who worked in the adult ICU and prescribed antifungal medications were individually interviewed. A semi-structured interview was used to ask core questions, followed by follow-up questions at the discretion of the interviewer.


RESULTS
Our analysis generated eight main emerging themes that were classified into three related groups. The main insights were that various interconnected reasons were given for the lack of conformity with regard to prescription patterns for antifungals. A negative cycle was perceived based on issues related to prescriptions and the search for knowledge. If problems related to individual actions and multidisciplinary team integration are resolved and local protocols are implemented based on local epidemiology, then barriers to proper prescriptions can be overcome when intensivists are faced with the unusual practice of prescribing antifungals.


CONCLUSIONS
Our investigation indicates the need for prescription assistance with support from a well-trained multidisciplinary team and consensus among its members and the importance of well-designed protocols.
Post Graduate Program in Biosciences Applied to Pharmacy, Universidade Estadual de Maringá, Maringá, Paraná, Brazil.
Tânia Pereira
TP
Salci
Adelia P
AP
Batilana
Ricardo
R
Pietrobon
Silvana Martins
SM
Caparroz-Assef
D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D003422:Critical Care; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D036301:Qualitative Research; D011787:Quality of Health Care; D013038:Specialization
D000935:Antifungal Agents
antifungal; barriers to prescription; intensive care unit; intensivist opinion; qualitative research; quality of health care