Drouin Denis, Campbell Norman R, Kaczorowski Janusz
Continuing Professional Development Centre, Laval University Faculty of Medicine, Quebec City, Canada.
Can J Cardiol. 2006 May 15;22(7):595-8. doi: 10.1016/s0828-282x(06)70281-1.
The diffusion of research evidence or practice guidelines does not, by itself, lead to changes in practice behaviour or patient outcomes. The Canadian Hypertension Education Program (CHEP) was specifically structured to have an explicit process to improve the ability of primary care professionals to use CHEP recommendations. The key features of this process are reviewed in the present report. The responsibility for implementation of recommendations is divided between the executive committee of CHEP and the Implementation Task Force (ITF). The executive develops an extensive array of summaries and implementation tools for the recommendations, and encourages and facilitates other organizations to develop educational materials and programs. The ITF creates further implementation tools, tailors the tools to specific health care disciplines and creates discipline-specific dissemination strategies. Currently, CHEP recommendations are disseminated through updated full scientific manuscripts, short scientific and clinical summaries, one-page handouts, wall posters, pocket cards, advertisements, extensive slide kits, textbooks, didactic lectures and workshops. A Web site with the recommendations in different formats is maintained to allow easy access. More recently, media releases have been used to alert the public and health care professionals to important recommendations. The transparent and interactive annual process of developing the recommendations by most of Canada's clinical hypertension experts is also viewed as critical to providing uniform educational messages to health care professionals from national and local opinion leaders. The CHEP ITF includes primary care disciplines and specialties important to blood pressure control. The CHEP process for the implementation of recommendations is very extensive and continues to evolve. There is early evidence for improvement in the management of hypertension in Canada that coincides with the initiation of CHEP, suggesting that CHEP could serve as a model for disease management recommendations.
研究证据或实践指南的传播本身并不会导致实践行为或患者预后的改变。加拿大高血压教育计划（CHEP）特意构建了一个明确的流程，以提高初级保健专业人员运用CHEP建议的能力。本报告回顾了该流程的关键特征。建议的实施责任由CHEP执行委员会和实施工作组（ITF）分担。执行委员会为各项建议制定了大量的总结和实施工具，并鼓励和促进其他组织开发教育材料和项目。ITF则创建更多的实施工具，针对特定的医疗保健学科对这些工具进行调整，并制定特定学科的传播策略。目前，CHEP的建议通过更新后的完整科学手稿、简短的科学和临床总结、单页资料、墙报、袖珍卡片、广告、丰富的幻灯片套件、教科书、教学讲座和研讨会等形式进行传播。还维护了一个包含不同格式建议的网站，以便于访问。最近，还利用媒体发布来提醒公众和医疗保健专业人员关注重要建议。加拿大大多数临床高血压专家制定建议的透明且互动的年度流程，也被视为向国家和地方意见领袖的医疗保健专业人员提供统一教育信息的关键。CHEP的ITF包括对血压控制至关重要的初级保健学科和专业。CHEP实施建议的流程非常广泛且仍在不断发展。有早期证据表明，在加拿大高血压管理方面的改善与CHEP的启动相吻合，这表明CHEP可作为疾病管理建议的一个范例。
