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计算机提醒对丹麦全科医疗即时检验室间质量评估效果的研究:两项随机试验的原理和方法。

The efficacy of computer reminders on external quality assessment for point-of-care testing in Danish general practice: rationale and methodology for two randomized trials.

机构信息

The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

出版信息

Implement Sci. 2011 Jul 23;6:79. doi: 10.1186/1748-5908-6-79.

Abstract

BACKGROUND

Point-of-care testing (POCT) is increasingly being used in general practice to assist general practitioners (GPs) in their management of patients with diseases. However, low adherence to quality guidelines in terms of split test procedures has been observed among GPs in parts of the Capital Region in Denmark. Computer reminders embedded in GPs electronic medical records (ComRem) may facilitate improved quality control behaviour, but more research is needed to identify what types of reminders work and when. The overall aim of this study is to evaluate the efficacy of ComRem to improve GPs adherence to quality guidelines. This article describes the rationale and methods of the study that constitute this research project.

METHODS/DESIGN: The study is conducted as two randomised controlled trials (RCTs) among general practices in two districts of the Capital Region in Denmark. These districts contain a total of 739 GPs in 567 practices with a total of 1.1 million patients allocated to practice lists. In the first RCT (RCT A), ComRem is compared to postal reminder letters. In the second RCT (RCT B), ComRem is compared to usual activities (no reminders) with a crossover approach. In both of these studies, outcomes are measured by the number of split tests received by the laboratory.

CONCLUSIONS

This study will contribute to knowledge on the efficacy of ComRem in primary care. Because the study does not explore GPs' perceptions and experiences with regard to ComRem, we will subsequently conduct a qualitative survey focusing on these aspects.

TRIAL REGISTRATIONS

Study A: ClinicalTrials.gov identifier: NCT01152151Study B: ClinicalTrials.gov identifier: NCT01152177.

摘要

背景

即时检验(POCT)越来越多地被用于全科医疗,以协助全科医生(GP)管理患者的疾病。然而,在丹麦首都地区的部分地区,GP 在拆分检测程序方面的质量指南的遵循率较低。嵌入在 GP 电子病历中的计算机提醒(ComRem)可能有助于改善质量控制行为,但需要更多的研究来确定哪种类型的提醒有效以及何时有效。本研究的总体目标是评估 ComRem 提高 GP 遵循质量指南的效果。本文介绍了构成该研究项目的研究的基本原理和方法。

方法/设计:该研究在丹麦首都地区的两个区的 567 家诊所中的 739 名 GP 中进行了两项随机对照试验(RCT)。这两个区共有 110 万名患者分配到诊所名单中。在第一项 RCT(RCT A)中,ComRem 与邮寄提醒信进行比较。在第二项 RCT(RCT B)中,ComRem 与常规活动(无提醒)进行了交叉比较。在这两项研究中,通过实验室收到的拆分测试数量来衡量结果。

结论

本研究将有助于了解 ComRem 在初级保健中的效果。由于该研究没有探讨 GP 对 ComRem 的看法和经验,因此我们将随后进行一项重点关注这些方面的定性调查。

试验注册

研究 A:ClinicalTrials.gov 标识符:NCT01152151;研究 B:ClinicalTrials.gov 标识符:NCT01152177。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0106/3158743/47196546adf7/1748-5908-6-79-1.jpg

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