Health Protection Team, Public Health NHS Lothian, Edinburgh, UK.
Sioux Lookout First Nations Health Authority, Sioux Lookout, Canada.
Br J Gen Pract. 2021 Aug 26;71(710):e652-e659. doi: 10.3399/BJGP.2020.0963. Print 2021 Sep.
Review templates are commonly used in long-term condition (LTC) consultations to standardise care for patients and promote consistent data recording. However, templates may affect interactions during the review and, potentially, inhibit patient-centred care.
To systematically review the literature about the impact that LTC review templates have on process and health outcomes, and the views of health professionals and patients on using review templates in consultations.
Parallel qualitative and quantitative systematic reviews.
Following Cochrane methodology, nine databases were searched (1995-2019; updated July 2020) for clinical trials and qualitative studies of LTC templates in healthcare settings. Duplicate selection, risk-of-bias assessment, and data extraction were performed. The quantitative and qualitative analyses were conducted in parallel, and findings synthesised narratively.
In total, 12 qualitative and 14 quantitative studies were included (two studies reported both qualitative and quantitative data, and were included in both analyses). Review templates were well used, but the only study to assess health outcomes showed no effect. Templates can improve documentation of key measures and act as a reminder tool; however, they can restrict the review process, and risk health professionals' agendas being prioritised over those of patients. Templates may also limit opportunities to discuss individuals' concerns about living with their condition and act as a barrier to providing patient-centred care.
Future research should evaluate health, as well as process, outcomes. The potential benefits of templates in improving documentation should be balanced against concerns that 'tick boxes' may override patient agendas, unless templates are designed to promote patient-centred care.
综述模板常用于长期护理（LTC）咨询中，以规范患者护理并促进数据记录的一致性。然而，模板可能会影响审查期间的互动，并可能抑制以患者为中心的护理。
系统评价综述模板对过程和健康结果的影响，以及卫生专业人员和患者对在咨询中使用综述模板的看法的文献。
平行的定性和定量系统评价。
根据 Cochrane 方法，在 1995 年至 2019 年期间（更新于 2020 年 7 月），在医疗保健环境中对 LTC 模板的临床试验和定性研究进行了九个数据库的搜索。对重复选择、偏倚风险评估和数据提取进行了评估。对定量和定性分析进行了平行分析，并进行了叙述性综合。
共纳入 12 项定性研究和 14 项定量研究（两项研究报告了定性和定量数据，并分别纳入了两种分析）。综述模板使用良好，但唯一一项评估健康结果的研究没有显示出效果。模板可以改善关键措施的记录，并作为提醒工具；然而，它们可能会限制审查过程，并使卫生专业人员的议程优先于患者的议程。模板还可能限制讨论个人对其病情的担忧的机会，并阻碍以患者为中心的护理。
未来的研究应该评估健康状况以及过程和结果。模板在改善记录方面的潜在好处应与担心“打勾”可能会凌驾于患者的议程之上相平衡，除非模板旨在促进以患者为中心的护理。
