Department of Community Health Sciences and the O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Clinical Neurosciences and the Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Department of Community Health Sciences and the O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Clinical Neurosciences and the Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Epilepsy Behav. 2019 Mar;92:265-268. doi: 10.1016/j.yebeh.2019.01.016. Epub 2019 Feb 4.
Clinical practice guidelines (CPGs) have the potential to improve quality of care. However, implementation of CPGs into the clinical care of people with epilepsy is less than optimal. This study aimed to examine barriers and facilitators to the use of CPGs for the care of people with epilepsy.
A cross-sectional survey of Canadian neurologists was conducted to evaluate CPG use, barriers and facilitators of CPG use, and factors associated with CPG use among neurologists. The barriers and facilitators of CPG use among neurologists that manage people with epilepsy were compared with those who do not.
Of 311 responders (response rate = 38.7%), 78.7% indicated that they manage people with epilepsy. Neurologists that manage people with epilepsy did not differ from those who do not with regard to demographic characteristics nor in the proportion that report using CPGs in their clinical practice. The barriers and facilitators of CPG use were largely similar between neurologist that do and do not manage people with epilepsy; except applicability of CPGs tended to be less commonly endorsed as a barrier to CPG use by those who manage people with epilepsy compared with those who do not.
This study suggests that knowledge, applicability, motivation, resources, and targeting of CPGs to appropriate audience are barriers and facilitators of CPG use among neurologists who manage people with epilepsy. The similarity between barriers and facilitators of CPG use among neurologists who manage people with epilepsy compared with those who do not provides support for the use of a knowledge translation (KT) strategy tailored to these barriers and facilitators of CPG use, and targeted towards neurologists. Implementation of epilepsy CPGs has the potential to improve the quality of care for people with epilepsy.
临床实践指南（CPG）有可能提高医疗质量。然而，将 CPG 应用于癫痫患者的临床护理的效果并不理想。本研究旨在探讨影响癫痫患者 CPG 使用的障碍和促进因素。
对加拿大神经科医生进行了横断面调查，以评估 CPG 的使用情况、CPG 使用的障碍和促进因素，以及与神经科医生 CPG 使用相关的因素。比较了管理癫痫患者的神经科医生与不管理癫痫患者的神经科医生在 CPG 使用方面的障碍和促进因素。
在 311 名应答者中（应答率为 38.7%），78.7%的人表示他们管理癫痫患者。管理癫痫患者的神经科医生与不管理癫痫患者的神经科医生在人口统计学特征方面没有差异，也没有报告在临床实践中使用 CPG 的比例存在差异。管理和不管理癫痫患者的神经科医生在 CPG 使用的障碍和促进因素方面基本相似；除了 CPG 的适用性，管理癫痫患者的神经科医生比不管理癫痫患者的神经科医生更倾向于将其作为 CPG 使用的障碍。
本研究表明，知识、适用性、动机、资源和 CPG 针对适当受众的定位是管理癫痫患者的神经科医生使用 CPG 的障碍和促进因素。管理和不管理癫痫患者的神经科医生在 CPG 使用的障碍和促进因素方面的相似性为针对这些障碍和促进因素制定和实施适合管理癫痫患者的神经科医生的知识转化（KT）策略提供了支持。实施癫痫 CPG 有可能提高癫痫患者的护理质量。
