School of Nursing and Midwifery, University of Southern Queensland, Toowoomba, Queensland, Australia
School of Nursing and Midwifery, University of Southern Queensland, Toowoomba, Queensland, Australia.
BMJ Open. 2020 Jul 20;10(7):e036060. doi: 10.1136/bmjopen-2019-036060.
Multifarious chronic obstructive pulmonary disease (COPD) guidelines have been published by local, national and global respiratory societies. These guidelines subsume holistic evidence based on recommendations to diagnose, treat, prevent and manage acute exacerbation with COPD. Despite the existing comprehensive recommendations, readmission rates and hospitalisations have increased in the last decade. Evidence to date has reported suboptimal clinical guidelines concordance. Acute exacerbations of COPD (AECOPD) is a common hospital presentation due to varied causes such as infective exacerbations, worsening disease condition, medication non-adherence, lack of education and incomprehensive discharge planning. AECOPD directly and indirectly causes economic burden, disrupts health-related quality of life (HRQol), hasten lung function decline and increases overall morbidity and mortality. COPD being a multimodal chronic disease, consistent interdisciplinary interventions from the time of admission to discharge may reduce readmissions and enhance HRQol among these patients and their families.
This protocol adheres to the Joanna Briggs Institute methodology for mixed methods systematic reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews reporting guidelines. Qualitative, quantitative and mixed methods studies will append this study to explore determinants of COPD guidelines concordance. Comprehensive three-tier search strategies will be used to search nine databases (COCHRANE, EBSCO HOST, MEDLINE, SCIENCE DIRECT, JBI, SCOPUS, WEB OF SCIENCE, WILEY and DARE) in May 2020. Two independent reviewers will screen abstracts and full-text articles in consonance with inclusion criteria. The convergent integrative method narrative review will contribute a deeper understanding of any discrepancies found in the existing evidence. Quality of the studies will be reported and Theoretical Domains Framework (TDF) will be used as a priori to synthesis data. Identified barriers, facilitators and corresponding clinical behavioural change solutions will be categorised using TDF indicators to provide future research and implementation recommendations.
Ethical approval is not required and results dissemination will occur through peer-reviewed publication.
当地、国家和全球呼吸学会已经发布了多种慢性阻塞性肺疾病（COPD）指南。这些指南综合了基于建议的整体循证医学，以诊断、治疗、预防和管理 COPD 急性加重。尽管现有的综合建议，在过去十年中，再入院率和住院率有所增加。迄今为止的证据报告了临床指南一致性欠佳。由于各种原因，如感染性加重、疾病恶化、药物不依从、缺乏教育和不全面的出院计划，COPD 急性加重（AECOPD）是一种常见的医院就诊原因。AECOPD 直接和间接导致经济负担、破坏健康相关生活质量（HRQol）、加速肺功能下降以及增加整体发病率和死亡率。COPD 是一种多模式的慢性疾病，从入院到出院的持续跨学科干预可能会降低这些患者及其家属的再入院率并提高 HRQol。
本方案遵循乔安娜·布里格斯研究所（Joanna Briggs Institute）混合方法系统评价方法和系统评价和荟萃分析扩展的首选报告项目（Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews）报告指南。定性、定量和混合方法研究将补充本研究，以探讨 COPD 指南一致性的决定因素。全面的三级搜索策略将于 2020 年 5 月在九个数据库（COCHRANE、EBSCO HOST、MEDLINE、SCIENCE DIRECT、JBI、SCOPUS、WEB OF SCIENCE、WILEY 和 DARE）中进行搜索。两名独立的评审员将根据纳入标准筛选摘要和全文文章。收敛综合方法叙述性综述将有助于更深入地了解现有证据中发现的任何差异。将报告研究质量，并使用理论领域框架（TDF）作为综合数据的先验框架。使用 TDF 指标对确定的障碍、促进因素和相应的临床行为改变解决方案进行分类，为未来的研究和实施提供建议。
不需要伦理批准，结果传播将通过同行评审出版物进行。
