骨关节炎指南：实施障碍及解决方案。
Osteoarthritis guidelines: Barriers to implementation and solutions.
机构信息
Department of Physiotherapy, Occupational Therapy and Speech Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil; Royal North Shore Hospital, Rheumatology Department, and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, NSW, Australia.
Service de rééducation et réadaptation de l'appareil locomoteur et des pathologies du rachis, hôpital Cochin, University Paris Descartes, PRES Sorbonne Paris Cité, Assistance publique-Hôpitaux de Paris, Paris, France.
出版信息
Ann Phys Rehabil Med. 2016 Jun;59(3):170-173. doi: 10.1016/j.rehab.2016.01.007. Epub 2016 Mar 3.
Osteoarthritis (OA) is a leading cause of disability worldwide. Clinical practice guidelines (CPGs) have been developed to facilitate improved OA management. Scientific communities worldwide have proposed CPGs for OA treatment. Despite the number of highly prominent guidelines available and their remarkable consistency, their uptake has been suboptimal. Possibly because of the multitude of barriers related to the implementation of CPGs. For example, different guidelines show contradictions, some lack evidence, and they lack a hierarchy or tools to facilitate their translation and application. Also, the guidelines do not acknowledge the effect of comorbidities on choosing the treatments. Finally, poor integration of multidisciplinary services within and across healthcare settings is a major barrier to the effective implementation of management guidelines. Here we describe the main problems related to the OA guidelines and some solutions so as to offer some guidance on the elaboration of future CPGs and their implementation in primary care.
骨关节炎（OA）是全球范围内导致残疾的主要原因。临床实践指南（CPG）的制定旨在促进 OA 管理的改善。全球科学界已经提出了 OA 治疗的 CPG。尽管有许多高度突出的指南可用，而且它们的一致性非常显著，但它们的采用情况并不理想。可能是因为与 CPG 实施相关的多种障碍。例如，不同的指南显示出矛盾，有些缺乏证据，并且它们缺乏层次结构或工具来促进它们的翻译和应用。此外，这些指南没有考虑到合并症对选择治疗方法的影响。最后，多学科服务在医疗保健环境内部和之间的整合不良是有效实施管理指南的主要障碍。在这里，我们描述了与 OA 指南相关的主要问题及一些解决方案，以期为未来 CPG 的制定及其在初级保健中的实施提供一些指导。
Zotero 插件