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全科医生对长期疾病治疗的益处和危害的使用和理解:一项定性访谈研究。

GPs' use and understanding of the benefits and harms of treatments for long-term conditions: a qualitative interview study.

机构信息

Nuffield Department of Primary Care Health Sciences, Oxford.

出版信息

Br J Gen Pract. 2021 Aug 26;71(710):e660-e667. doi: 10.3399/BJGP.2020.1027. Print 2021 Sep.

Abstract

BACKGROUND

To support shared decision making and improve the management of polypharmacy, it is recommended that GPs take into account quantitative information on the benefits and harms of treatments (QIRx). Quantitative evidence shows GPs' knowledge of this is low.

AIM

To explore GPs' attitudes to and understanding of QIRx for long-term conditions.

DESIGN AND SETTING

Qualitative interview study in UK general practice.

METHOD

Semi-structured interviews were carried out with 15 GPs. Audiorecordings were transcribed verbatim and a framework approach was used for analysis.

RESULTS

Participants described knowing or using QIRx for only a few treatments. There was awareness of this knowledge deficit coupled with low confidence in statistical terminology. Some GPs perceived an absence of this information as an important barrier to optimal care, while others were content to follow guidelines. In the absence of this knowledge, other strategies were described to individualise treatment decisions. The idea of increasing the use of QIRx appealed to most participants, with imagined benefits for patients and themselves. However, potential barriers were described: a need for accessible information that can be understood and integrated into real-world practice, system factors, and communication challenges.

CONCLUSION

GPs were aware of their knowledge deficit with regard to an understanding of QIRx. Most participants were positive about the idea of increasing their use of QIRx in practice but described important challenges, which need to be considered when designing solutions.

摘要

背景

为了支持共同决策和改善多重用药管理,建议全科医生考虑治疗的效益和危害的定量信息(QIRx)。定量证据表明,全科医生对此知之甚少。

目的

探讨全科医生对长期疾病的 QIRx 的态度和理解。

设计和设置

在英国普通实践中进行定性访谈研究。

方法

对 15 名全科医生进行了半结构化访谈。录音逐字转录,并使用框架方法进行分析。

结果

参与者仅描述了对几种治疗方法的了解或使用 QIRx。他们意识到这种知识不足,同时对统计术语缺乏信心。一些全科医生认为缺乏这种信息是最佳护理的一个重要障碍,而另一些则满足于遵循指南。在缺乏这种知识的情况下,还描述了其他策略来个性化治疗决策。大多数参与者都认为增加 QIRx 的使用对患者和自己都有好处。然而,也描述了潜在的障碍:需要易于理解和整合到实际实践中的信息、系统因素和沟通挑战。

结论

全科医生意识到他们对 QIRx 理解的知识不足。大多数参与者对增加 QIRx 在实践中的使用持积极态度,但描述了一些重要的挑战,在设计解决方案时需要考虑这些挑战。

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