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临床实践中基于证据的骨密度检测申请的可接受性与可行性

Acceptability and Feasibility of an Evidence-Based Requisition for Bone Mineral Density Testing in Clinical Practice.

作者信息

Munce Sarah E P, Butt Debra A, Anantharajah Rokeni Sumi, Huang Susana, Allin Sonya, Bereket Tarik, Jaglal Susan B

机构信息

Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada; Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.

Department of Family and Community Medicine, University of Toronto, Research Department, Toronto, ON, Canada; Family and Community Medicine, The Scarborough Hospital, Scarborough, ON, Canada.

出版信息

J Osteoporos. 2016;2016:6967232. doi: 10.1155/2016/6967232. Epub 2016 Dec 6.

Abstract

The purpose of this study is to understand the experience of primary care providers (PCPs) using an evidence-based requisition for bone mineral density (BMD) testing. A qualitative descriptive approach was adopted. Participants were given 3 BMD Recommended Use Requisitions (RUR) to use over a 2-month period. Twenty-six PCPs were interviewed before using the RUR. Those who had received at least one BMD report resulting from RUR use were then interviewed again. An inductive thematic analysis was performed. We identified four themes in interview data: (1) positive and negative characteristics of the RUR, (2) facilitators and barriers for implementation, (3) impact of the RUR, and (4) requisition preference. Positive characteristics of the RUR related to both its content and format. Negative characteristics related to the increased amount of time needed to complete the form. Facilitators to implementation included electronic availability and organizational endorsement. Time constraints were identified as a barrier to implementation. Participants perceived that the RUR would promote appropriate referrals and the majority of participants preferred the RUR to their current requisition. Findings from this study provide support for the RUR as an acceptable point-of-care tool for PCPs to promote appropriate BMD testing.

摘要

本研究的目的是了解初级保健提供者(PCP)使用基于证据的骨密度(BMD)检测申请单的体验。采用了定性描述方法。参与者在两个月的时间内使用3份BMD推荐使用申请单(RUR)。26名PCP在使用RUR之前接受了访谈。那些因使用RUR而收到至少一份BMD报告的人随后再次接受访谈。进行了归纳主题分析。我们在访谈数据中确定了四个主题:(1)RUR的积极和消极特征,(2)实施的促进因素和障碍,(3)RUR的影响,以及(4)申请单偏好。RUR的积极特征与其内容和格式有关。消极特征与完成表格所需的时间增加有关。实施的促进因素包括电子可用性和组织认可。时间限制被确定为实施的障碍。参与者认为RUR将促进适当的转诊,并且大多数参与者更喜欢RUR而不是他们目前的申请单。本研究的结果为RUR作为PCP促进适当BMD检测的可接受的即时护理工具提供了支持。

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