van Balkom A J L M, Oosterbaan D B
VU Medisch Centrum, Amsterdam, The Netherlands.
Tijdschr Psychiatr. 2008;50(6):323-8.
It appears from a review of the literature that at present a considerable number of psychiatric patients are being deprived of evidence-based treatment. However, Australian theoretical research has shown that if patients were to be treated entirely in accordance with evidence-based guidelines they would derive considerably more benefit from their treatment. This conclusion has been corroborated by various randomised controlled trials (RCT's) in which the effect of evidence-based treatment according to guidelines is compared with the effect of 'treatment as usual'. Studies carried out under less controlled circumstances than those prevailing in RCT's yield slightly less positive results. The literature stresses the difficulties of improving the quality of patient care. Studies on the implementations of guidelines show that carefully constructed, tailor-made interventions are needed to ensure that professionals adhere to guidelines. More research is required into effective ways of implementing guidelines in an adequate manner.
从文献综述来看，目前相当多的精神科患者被剥夺了循证治疗。然而，澳大利亚的理论研究表明，如果患者完全按照循证指南接受治疗，他们将从治疗中获得更多益处。这一结论已得到各种随机对照试验（RCT）的证实，在这些试验中，将循证指南治疗的效果与“常规治疗”的效果进行了比较。在比RCT中普遍存在的情况控制较差的环境下进行的研究，得到的积极结果略少。文献强调了提高患者护理质量的困难。关于指南实施的研究表明，需要精心构建、量身定制的干预措施，以确保专业人员遵守指南。需要对以适当方式实施指南的有效方法进行更多研究。
