Kaiser Rolf
Department of Clinical Pharmacology, University Medical Centre Georg-August University Göttingen, Germany.
Lancet Oncol. 2005 Aug;6(8):622-5. doi: 10.1016/S1470-2045(05)70284-9.
Evidence-based guidelines are regarded as therapeutic standards for many medical interventions. However, implementation of such recommendations seems to be rather difficult. An international antiemetic guideline for the treatment of patients undergoing chemotherapy was issued by the Multinational Association of Supportive Care in Cancer in 1997 and has been in use ever since. However, for many reasons, the guideline has not been followed completely, despite the fact that if antiemetics are used in accordance with guidelines, efficacy is similar to that achieved in randomised controlled trials. Structural difficulties, patients characteristics, and other barriers, such as the individual acceptance of guidelines and education of physicians and nurses, could be crucial factors for successful implementation. Thus, better adherence to antiemetic guidelines can only be achieved through a complex and long-term process, consisting of efficient education, training, and monitoring of all individuals involved.
循证指南被视为许多医学干预措施的治疗标准。然而，实施这些建议似乎相当困难。1997年，多国癌症支持治疗协会发布了一项关于化疗患者治疗的国际止吐指南，此后一直在使用。然而，由于多种原因，尽管按照指南使用止吐药的疗效与随机对照试验所取得的疗效相似，但该指南并未得到完全遵循。结构上的困难、患者特征以及其他障碍，如个人对指南的接受程度以及医生和护士的教育情况，可能是成功实施的关键因素。因此，只有通过一个复杂且长期的过程，包括对所有相关人员进行有效的教育、培训和监测，才能更好地遵循止吐指南。
