Nast Alexander, Erdmann Ricardo, Pathirana Delano, Rzany Berthold
Division of Evidence Based Medicine, Klinik für Dermatology, Charité Universitätsmedizin Berlin, Berlin, Germany.
J Eval Clin Pract. 2008 Oct;14(5):803-6. doi: 10.1111/j.1365-2753.2008.00971.x.
Evidence-based guidelines can make a substantial contribution to improving medical care. However, it is important to ensure that guidelines are: (1) developed in areas in which they are needed the most; and (2) translated effectively into everyday clinical practice.
To evaluate the need for guidelines in the treatment of psoriasis vulgaris, the success of the dissemination activities undertaken to date, and the potential benefits of educational interventions in encouraging guideline compliance.
All dermatologists working in the Berlin-Brandenburg region of Germany were invited to attend a workshop on the psoriasis treatment guidelines. Participants could take part in a survey examining the general need for psoriasis guidelines and the success of previous dissemination activities.
A total of 42% of survey participants had not received a copy of the guidelines prior to the workshop. Of those who had received a copy, only 15% had studied the guidelines in detail. In total, 76% of survey participants felt that physicians' low levels of confidence in administering systemic treatments had resulted in these treatment options being used less frequently than they should. Seventy-nine per cent of survey participants believed that the guidelines would be helpful in improving physicians' confidence and ultimately lead to an increased use of systemic treatments.
The results of the present study indicate that there is a great need for guidelines on the treatment of psoriasis vulgaris in Germany, especially in light of dermatologists' low levels of confidence administering systemic treatments. Strategies for broad dissemination are essential for proper guideline implementation.
循证指南对改善医疗护理可做出重大贡献。然而,确保指南具备以下两点很重要:(1)在最需要的领域制定;(2)有效转化为日常临床实践。
评估寻常型银屑病治疗指南的需求、迄今开展的传播活动的成效,以及教育干预在鼓励遵循指南方面的潜在益处。
邀请所有在德国柏林 - 勃兰登堡地区工作的皮肤科医生参加关于银屑病治疗指南的研讨会。参与者可参与一项调查,该调查探讨银屑病指南的总体需求以及以往传播活动的成效。
共有42%的调查参与者在研讨会前未收到指南副本。在收到副本的人中,只有15%详细研读了指南。总体而言,76%的调查参与者认为医生在给予全身治疗方面信心不足,导致这些治疗方案的使用频率低于应有的水平。79%的调查参与者认为指南将有助于提高医生的信心,并最终增加全身治疗的使用。
本研究结果表明,德国对寻常型银屑病治疗指南有很大需求,尤其是考虑到皮肤科医生在给予全身治疗方面信心不足。广泛传播的策略对于指南的正确实施至关重要。