Gagné Myriam E, Boulet Louis-Philippe
a Knowledge Translation, Education and Prevention Chair in Respiratory and Cardiovascular Health , Laval University , Quebec City , Quebec , Canada.
b Quebec Heart and Lung Institute , Quebec City , Quebec , Canada.
J Asthma. 2018 Mar;55(3):310-317. doi: 10.1080/02770903.2017.1323919. Epub 2017 May 26.
Based on the Knowledge-to-Action Cycle, we assessed the self-reported implementation and perception of asthma clinical practice guideline (CPG) recommendations in primary care physicians (PCPs), along with the barriers and facilitators to CPG use in primary care.
We conducted a cross-sectional study. Using the extended Asthma Physicians' Practice Assessment Questionnaire, PCPs self-reported the following: their knowledge of 15 key asthma CPG recommendations, the perceived usefulness of each of these recommendations, their motivation to apply these recommendations, and their agreement with the content of these recommendations. Participants also reported the barriers and facilitators to CPG use in primary care.
Out of the 46 potential participants, 43 physicians completed the questionnaire (response rate: 93%). Results underlined care gaps regarding the provision of asthma education and written action plans, inhaler technique demonstrations, and assessment of patients' concerns. Results showed that the majority of physicians knew the key asthma CPG recommendations, but their motivation to implement them and the perceived usefulness of these recommendations varied from one proposal to another. Main barriers to the implementation of these recommendations were related to time and resources. PCPs stressed the importance of teamwork for enhancing the use of asthma CPGs in primary care.
Our results suggest that the implementation of asthma CPGs remains suboptimal in primary care. Interventions addressing the identified barriers and providing facilitators to asthma CPG implementation, such as continuing education, could be implemented and evaluated to sustain asthma CPG use in primary care settings.
基于知识转化行动循环，我们评估了基层医疗医生（PCP）对哮喘临床实践指南（CPG）建议的自我报告实施情况和认知，以及基层医疗中使用CPG的障碍和促进因素。
我们开展了一项横断面研究。使用扩展版哮喘医生实践评估问卷，PCP自我报告以下内容：他们对15项关键哮喘CPG建议的了解、对每项建议的感知有用性、应用这些建议的动机以及对这些建议内容的认同度。参与者还报告了基层医疗中使用CPG的障碍和促进因素。
在46名潜在参与者中，43名医生完成了问卷（回复率：93%）。结果突显了在提供哮喘教育和书面行动计划、吸入器技术演示以及评估患者担忧方面的护理差距。结果表明，大多数医生了解关键哮喘CPG建议，但他们实施这些建议的动机以及对这些建议的感知有用性因建议而异。实施这些建议的主要障碍与时间和资源有关。PCP强调团队合作对于在基层医疗中加强哮喘CPG使用的重要性。
我们的结果表明，哮喘CPG在基层医疗中的实施仍未达到最佳状态。可以实施并评估针对已确定障碍并为哮喘CPG实施提供促进因素的干预措施，如继续教育，以维持基层医疗环境中哮喘CPG的使用。
