Sebo Paul, Maisonneuve Hubert, Cerutti Bernard, Fournier Jean-Pascal, Senn Nicolas, Rat Cédric, Haller Dagmar M
Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Unit of Research and Development in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
PLoS One. 2017 Sep 5;12(9):e0184032. doi: 10.1371/journal.pone.0184032. eCollection 2017.
A range of preventive practices are recommended to reduce the burden of chronic diseases. The aim of our study was to describe the preventive practices of French-speaking primary care physicians.
A cross-sectional survey was conducted in 2015 in a randomly selected sample of 1100 primary care physicians (700 in Switzerland, 400 in France). The physicians were asked how often they performed the following recommended preventive practices: blood pressure, weight and height measurements, screening for dyslipidemia, screening for alcohol use and brief intervention, screening for smoking (and brief advice for smokers), colon and prostate cancer screening, and influenza immunization. Response options on the five points Likert scale were never, rarely, sometimes, often, always. The physicians were considered to be performing the preventive practice regularly if they declared performing it often or always.
518 participants (47%) returned the questionnaire. The most commonly reported preventive practices were: blood pressure measurement (99%), screening for smoking (95%) and brief advice for smokers (95%). The least frequently reported practices were annual influenza immunization for at-risk patients <65 years (37%), height measurement (53%), screening for excessive alcohol use (60%) and brief advice for at-risk drinkers (67%). All other practices were reported by 70 to 90% of participants.
Whereas some preventive practices now appear to be part of primary care routine, others were not applied by a large proportion of primary care physicians in our study. Further studies should explore whether these findings are related to miss-knowledge of common guidelines, or other implementation barriers in this primary care context.
推荐了一系列预防措施以减轻慢性病负担。我们研究的目的是描述说法语的初级保健医生的预防措施。
2015年对1100名初级保健医生(瑞士700名,法国400名)的随机抽样样本进行了横断面调查。询问医生他们执行以下推荐预防措施的频率:血压、体重和身高测量、血脂异常筛查、酒精使用筛查及简短干预、吸烟筛查(以及对吸烟者的简短建议)、结肠癌和前列腺癌筛查以及流感免疫接种。采用五点李克特量表的回答选项为从不、很少、有时、经常、总是。如果医生宣称经常或总是执行某项预防措施,则认为他们定期执行该预防措施。
518名参与者(47%)返还了问卷。最常报告的预防措施是:血压测量(99%)、吸烟筛查(95%)和对吸烟者的简短建议(95%)。报告频率最低的措施是对65岁以下高危患者进行年度流感免疫接种(37%)、身高测量(53%)、过度酒精使用筛查(60%)和对高危饮酒者的简短建议(67%)。其他所有措施的报告率为70%至90%。
虽然现在一些预防措施似乎已成为初级保健常规工作的一部分,但在我们的研究中,很大一部分初级保健医生并未采用其他一些措施。进一步的研究应探讨这些发现是否与对常见指南的误解或该初级保健环境中的其他实施障碍有关。