Paneque Milena, Turchetti Daniela, Jackson Leigh, Lunt Peter, Houwink Elisa, Skirton Heather
i3S Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.
IBMC - Institute for Molecular and Cell Biology, UnIGENe and Centre for Predictive and Preventive Genetics (CGPP), Universidade do Porto, Porto, Portugal.
BMC Fam Pract. 2016 Jul 22;17:89. doi: 10.1186/s12875-016-0483-2.
At least 10 % of patients seen in primary care are said to have a condition in which genetics has an influence. However, patients at risk of genetic disease may not be recognised, while those who seek advice may not be referred or managed appropriately. Primary care practitioners lack knowledge of genetics and genetic testing relevant for daily practice and feel inadequate to deliver genetic services. The aim of this systematic review was to evaluate genetics educational interventions in the context of primary care.
Following the process for systematic reviews developed by the Centre for Reviews and Dissemination, we conducted a search of five relevant electronic databases. Primary research papers were eligible for inclusion if they included data on outcomes of interventions regarding genetics education for primary care practitioners. The results from each paper were coded and grouped under themes.
Eleven studies were included in the review. The five major themes identified inductively (post hoc) were: prior experience, changes in confidence, changes in knowledge, changes in practice, satisfaction and feedback. In five of the studies, knowledge of practitioners was improved following the educational programmes, but this tended to be in specific topic areas, while practitioner confidence improved in six studies. However, there was little apparent change to practice.
There are insufficient studies of relevant quality to inform educational interventions in genetics for primary care practitioners. Educational initiatives should be assessed using changes in practice, as well as in confidence and knowledge, to determine if they are effective in causing significant changes in practice in genetic risk assessment and appropriate management of patients.
据说在初级保健机构就诊的患者中,至少10%患有受遗传学影响的疾病。然而,可能未识别出有遗传疾病风险的患者,而寻求建议的患者可能未得到适当转诊或管理。初级保健从业者缺乏与日常实践相关的遗传学和基因检测知识,并且觉得自己没有能力提供遗传服务。本系统评价的目的是评估初级保健背景下的遗传学教育干预措施。
按照循证医学与传播中心制定的系统评价流程,我们检索了五个相关电子数据库。如果初级研究论文包含有关针对初级保健从业者的遗传学教育干预结果的数据,则有资格纳入。对每篇论文的结果进行编码并按主题分组。
该评价纳入了11项研究。归纳得出的五个主要主题是:既往经验、信心变化、知识变化、实践变化、满意度和反馈。在五项研究中,教育项目实施后从业者的知识有所提高,但这往往局限于特定主题领域,而在六项研究中从业者的信心有所提高。然而,实践方面几乎没有明显变化。
缺乏足够高质量的研究来为针对初级保健从业者的遗传学教育干预提供参考。应通过实践、信心和知识的变化来评估教育举措,以确定它们是否能有效促使在遗传风险评估和患者适当管理方面的实践发生重大变化。