教育干预措施在改善基层医疗中痴呆症检测与管理方面的有效性：整群随机对照研究
Effectiveness of educational interventions in improving detection and management of dementia in primary care: cluster randomised controlled study.
作者信息
Downs Murna, Turner Stephen, Bryans Michelle, Wilcock Jane, Keady John, Levin Enid, O'Carroll Ronan, Howie Kate, Iliffe Steve
机构信息
Bradford Dementia Group, Division of Dementia Studies, School of Health Studies, University of Bradford, Bradford BD5 0BB.
出版信息
BMJ. 2006 Mar 25;332(7543):692-6. doi: 10.1136/bmj.332.7543.692.
OBJECTIVE
To test the effectiveness of educational interventions in improving detection rates and management of dementia in primary care.
DESIGN
Unblinded, cluster randomised, before and after controlled study.
SETTING
General practices in the United Kingdom (central Scotland and London) between 1999 and 2002.
INTERVENTIONS
Three educational interventions: an electronic tutorial carried on a CD Rom; decision support software built into the electronic medical record; and practice based workshops.
PARTICIPANTS
36 practices participated in the study. Eight practices were randomly assigned to the electronic tutorial; eight to decision support software; 10 to practice based workshops; and 10 to control. Electronic and manual searches yielded 450 valid and usable medical records.
MAIN OUTCOME MEASURES
Rates of detection of dementia and the extent to which medical records showed evidence of improved concordance with guidelines regarding diagnosis and management.
RESULTS
Decision support software (P = 0.01) and practice based workshops (P = 0.01) both significantly improved rates of detection compared with control. There were no significant differences by intervention in the measures of concordance with guidelines.
CONCLUSIONS
Decision support systems and practice based workshops are effective educational approaches in improving detection rates in dementia.
目的
测试教育干预措施在提高初级保健中痴呆症的检出率及管理水平方面的有效性。
设计
非盲法、整群随机、前后对照研究。
地点
1999年至2002年期间英国（苏格兰中部和伦敦）的全科诊所。
干预措施
三种教育干预措施：光盘上的电子教程；电子病历中内置的决策支持软件；以及基于实践的研讨会。
参与者
36家诊所参与了该研究。8家诊所被随机分配到电子教程组；8家到决策支持软件组；10家到基于实践的研讨会组；10家为对照组。通过电子和手动检索获得了450份有效且可用的病历。
主要观察指标
痴呆症的检出率以及病历显示在诊断和管理方面与指南的一致性得到改善的程度。
结果
与对照组相比，决策支持软件（P = 0.01）和基于实践的研讨会（P = 0.01）均显著提高了检出率。在与指南一致性的测量方面，各干预措施之间没有显著差异。
结论
决策支持系统和基于实践的研讨会是提高痴呆症检出率的有效教育方法。
Zotero 插件