Joore Ivo Kim, van Bergen Jan E A M, Ter Riet Gerben, van der Maat A, van Dijk N
Department of General Practice, Academic Medical Center, Amsterdam, The Netherlands.
Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
BMC Fam Pract. 2018 Mar 7;19(1):36. doi: 10.1186/s12875-018-0723-8.
In the Netherlands, a substantial proportion of newly diagnosed HIV patients present late for care, therefore, we investigated the effectiveness of a blended educational programme for trainers of GPs designed to stimulate proactive HIV testing.
GP trainers at the Academic Medical Center in Amsterdam were invited to participate in a two days training programme incorporating evidence-based practice guidelines and multiple teaching strategies, including interactive lectures, discussion groups, e-learning and quality improvement targets. The GP trainers completed questionnaires before and after the programme to evaluate the effect of the programme. We also used six-monthly cumulative laboratory data from 2010 to 2015 to compare the participating GPs' HIV tests to the general trend in testing among non-participating GPs.
150 GP trainers attended the first session, and 74 completed the questionnaires for both sessions. GPs median score on achieving their quality improvement targets was high and the quality of the programme highly appreciated. Between 2010 and 2013, the mean annual number of laboratory-documented HIV tests decreased by 9.1% in the 624 GPs in the control group, and by 13.0% for 11 GPs in the intervention group. After the programme, the annual decreases were 2.3% and 1.8%, respectively. Before the programme, the GPs in the intervention group had 50% more laboratory-documented HIV tests than GPs in the control group. After the programme, GPs in the intervention group had twice as many laboratory-documented HIV tests as the controls.
We provided a detailed description of a programme based on educational and clinical evidence. We could not retrieve laboratory-documented HIV testing data for the majority of GPs in both the intervention and control groups. Therefore, the limited results should be interpreted with caution as our findings may not be representative of all participants. The blended educational programme appears to have stabilized - at a higher level - the initially stronger downward trend in testing for 11 GPs undergoing the intervention, indicating that the programme may have had an impact on their HIV testing behaviour.
在荷兰，很大一部分新诊断出的艾滋病毒患者就诊较晚，因此，我们调查了一项针对全科医生培训师的混合式教育计划的有效性，该计划旨在促进积极主动的艾滋病毒检测。
邀请阿姆斯特丹学术医疗中心的全科医生培训师参加为期两天的培训计划，该计划纳入了循证实践指南和多种教学策略，包括互动讲座、讨论小组、电子学习和质量改进目标。全科医生培训师在该计划前后完成问卷调查，以评估该计划的效果。我们还使用了2010年至2015年的半年累计实验室数据，将参与计划的全科医生的艾滋病毒检测情况与未参与计划的全科医生的总体检测趋势进行比较。
150名全科医生培训师参加了第一期培训，74人完成了两期培训的问卷调查。全科医生在实现质量改进目标方面的中位数得分较高，该计划的质量也得到高度评价。2010年至2013年期间，对照组的624名全科医生中，实验室记录的艾滋病毒检测年均数量下降了9.1%，干预组的11名全科医生中下降了13.0%。该计划实施后，年均下降率分别为2.3%和1.8%。在该计划实施前，干预组的全科医生的实验室记录的艾滋病毒检测数量比对照组多50%。该计划实施后，干预组的全科医生的实验室记录的艾滋病毒检测数量是对照组的两倍。
我们提供了一个基于教育和临床证据的计划的详细描述。我们无法获取干预组和对照组中大多数全科医生的实验室记录的艾滋病毒检测数据。因此，由于我们的研究结果可能不代表所有参与者，有限的结果应谨慎解释。混合式教育计划似乎在更高水平上稳定了11名接受干预的全科医生最初较强的检测下降趋势，表明该计划可能对他们的艾滋病毒检测行为产生了影响。
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