Liu Bette, Donovan Basil, Hocking Jane S, Knox Janet, Silver Bronwyn, Guy Rebecca
The Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia.
Infect Dis Obstet Gynecol. 2012;2012:325108. doi: 10.1155/2012/325108. Epub 2012 Aug 29.
Evidence suggests adherence to clinical guidelines for pelvic inflammatory disease (PID) diagnosis and management is suboptimal. We systematically reviewed the literature for studies describing strategies to improve the adherence to PID clinical guidelines.
The databases MEDLINE and EMBASE, and reference lists of review articles were searched from January 2000 to April 2012. Only studies with a control group were included.
An interrupted time-series study and two randomised controlled trials (RCTs) were included. The interrupted time-series found that following a multifaceted patient and practitioner intervention (practice protocol, provision of antibiotics on-site, written instructions for patients, and active followup), more patients received the recommended antibiotics and attended for followup. One RCT found a patient video on PID self-care did not improve medication compliance and followup. Another RCT found an abbreviated PID treatment guideline for health-practitioners improved their management of PID in hypothetical case scenarios but not their diagnosis of PID.
There is limited research on what strategies can improve practitioner and patient adherence to PID diagnosis and management guidelines. Interventions that make managing PID more convenient, such as summary guidelines and provision of treatment on-site, appear to lead to better adherence but further empirical evidence is necessary.
有证据表明，盆腔炎性疾病（PID）诊断和管理的临床指南依从性欠佳。我们系统回顾了文献中描述改善PID临床指南依从性策略的研究。
检索了2000年1月至2012年4月期间的MEDLINE和EMBASE数据库以及综述文章的参考文献列表。仅纳入有对照组的研究。
纳入了一项中断时间序列研究和两项随机对照试验（RCT）。中断时间序列研究发现，经过多方面的患者和从业者干预（实践方案、现场提供抗生素、为患者提供书面说明以及积极随访）后，更多患者接受了推荐的抗生素治疗并前来随访。一项RCT发现，关于PID自我护理的患者视频并未提高药物依从性和随访率。另一项RCT发现，针对卫生从业者的简化PID治疗指南在假设病例场景中改善了他们对PID的管理，但未改善其对PID的诊断。
关于哪些策略可以提高从业者和患者对PID诊断和管理指南的依从性的研究有限。使PID管理更便捷的干预措施，如简要指南和现场提供治疗，似乎能带来更好的依从性，但还需要更多实证证据。
