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一项关于耳鼻喉科医生对中国变应性鼻炎诊断和治疗指南依从性的全国性调查。

A nationwide survey of otolaryngologists' compliance with Chinese guidelines for diagnosis and treatment of allergic rhinitis.

作者信息

Cheng Lei, Li Hua-Bin, Zhang Ya-Mei, Zhao Chang-Qing, Chen Fu-Quan, Shi Li, Li Na, Yang Bei-Bei, Li Yong, Li Hui-Jun, Ye Sheng-Nan, Tao Ze-Zhang, Zhang Ge-Hua, Xu Rui, Yang Qin-Tai, Zhu Dong-Dong, Liu Feng, Zhang Hua, Yang Yu-Cheng, Lin Peng, Qiu Chang-Yu, Zhou Bing

机构信息

Department of Otorhinolaryngology & Clinical Allergy Center, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China.

International Centre for Allergy Research, Nanjing Medical University, Nanjing, China.

出版信息

World Allergy Organ J. 2021 Jun 7;14(6):100552. doi: 10.1016/j.waojou.2021.100552. eCollection 2021 Jun.

Abstract

BACKGROUND

A higher compliance with clinical guidelines helps improve treatment outcomes. But the clinical practice of otolaryngologists is not always consistent with guidelines.

OBJECTIVE

To describe otolaryngologists' compliance with guidelines about allergic rhinitis (AR) management and identify factors responsible for the discordance between clinical practice and guideline recommendations in China.

METHODS

A cross-sectional nationwide survey was designed and conducted via an online platform. Recruitment was done by emailing otolaryngologists registered in the Chinese Society of Otorhinolaryngology-Head and Neck Surgery or by inviting otolaryngologists to scan a Quick Respond (QR) code that linked to the questionnaire at various academic meetings.

RESULTS

A total of 2142 otolaryngologists were eligible and completed the survey. Of them, 64.7% had over 10 years work experience and 97.4% had a bachelor's degree or higher. About 18.3% of the participants strictly copied the guideline in clinical practice, while 73.7% used the guideline that had been adjusted according to their clinical experience. Otolaryngologists were most concerned about the efficacy, safety, and minimum age of AR medications, and least concerned about patient preferences. Regarding the use of intranasal steroids (INS), leukotriene receptor antagonists (LTRA), and H1-antihistamines, 86.8%, 55.7% and 51.2% of otolaryngologists complied with the guideline recommendations, respectively. Educational background was a factor affecting the compliance with guidelines and acceptance of INS.

CONCLUSION

A vast majority of Chinese otolaryngologists complied with the current Chinese AR guidelines. A difference still existed between the otolaryngologists' real-world and guideline-recommended management. The otolaryngologists should pay more attention to patient preferences. A higher education could improve otolaryngologists' adherence to the guidelines.

摘要

背景

更高程度地遵循临床指南有助于改善治疗效果。但耳鼻喉科医生的临床实践并不总是与指南一致。

目的

描述耳鼻喉科医生对变应性鼻炎(AR)管理指南的遵循情况,并确定中国临床实践与指南建议不一致的相关因素。

方法

设计并通过在线平台开展一项全国性横断面调查。通过向中华医学会耳鼻咽喉头颈外科学分会注册的耳鼻喉科医生发送电子邮件,或在各种学术会议上邀请耳鼻喉科医生扫描与问卷相关联的二维码来进行招募。

结果

共有2142名耳鼻喉科医生符合条件并完成了调查。其中,64.7%有超过10年的工作经验,97.4%拥有学士学位或更高学历。约18.3%的参与者在临床实践中严格照搬指南,而73.7%使用根据其临床经验调整后的指南。耳鼻喉科医生最关注AR药物的疗效、安全性和最小适用年龄,最不关注患者偏好。关于鼻用糖皮质激素(INS)、白三烯受体拮抗剂(LTRA)和H1抗组胺药的使用,分别有86.8%、55.7%和51.2%的耳鼻喉科医生遵循了指南建议。教育背景是影响对指南的遵循以及对INS接受程度的一个因素。

结论

绝大多数中国耳鼻喉科医生遵循了现行的中国AR指南。耳鼻喉科医生的实际管理与指南推荐的管理之间仍存在差异。耳鼻喉科医生应更加关注患者偏好。更高的教育水平可提高耳鼻喉科医生对指南的依从性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e56b/8192728/a8a9893ee18f/gr2.jpg

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