School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Infectious Diseases Unit, Alfred Health, Melbourne, Australia.
J Clin Epidemiol. 2022 Mar;143:11-21. doi: 10.1016/j.jclinepi.2021.11.035. Epub 2021 Nov 28.
The Australian National COVID-19 Clinical Evidence Taskforce is developing living, evidence-based, national guidelines for treatment of people with COVID-19. These living guidelines are updated each week. We undertook an impact evaluation to understand the extent to which health professionals providing treatment to people with COVID 19 were aware of, valued and used the guidelines, and the factors that enabled or hampered this.
A mixed methods approach was used for the evaluation. Surveys were conducted to collect both quantitative and qualitative data and were supplemented with qualitative interviews. Australian healthcare practitioners potentially providing care to individuals with suspected or confirmed COVID-19 were invited to participate. Data were collected on guideline awareness, relevance, ease of use, trustworthiness, value, importance of updating, use, and strengths and opportunities for improvement.
A total of 287 people completed the surveys and 10 interviews were conducted during November 2020. Awareness of the work of the Taskforce was high and the vast majority of respondents reported that the guidelines were very or extremely relevant, easy to use, trustworthy and valuable. More than 50% of respondents had used the guidelines to support their own clinical decision-making; and 30% were aware of other examples of the guidelines being used. Qualitative data revealed that amongst an overwhelming morass of evidence and opinions during the COVID-19 pandemic, the guidelines have been a reliable, united source of evidence-based advice; participants felt the guidelines built confidence and provided reassurance in clinical decision-making. Opportunities to improve awareness and accessibility to the guidelines were also explored.
As of June 2021, the guidelines have been published and updated more than 40 times, include more than 140 recommendations and are being used to inform clinical decisions. The findings of this impact evaluation will be used to improve processes and outputs of the Taskforce and guidelines project, and to inform future living guideline projects.
澳大利亚国家 COVID-19 临床证据工作组正在制定针对 COVID-19 患者的治疗的、基于证据的、全国性的实用指南。这些实用指南每周更新一次。我们进行了一项影响评估,以了解为 COVID-19 患者提供治疗的卫生专业人员对指南的知晓程度、重视程度和使用情况,以及促进或阻碍这一点的因素。
采用混合方法对评估进行研究。进行了调查以收集定量和定性数据,并辅以定性访谈。邀请了可能为疑似或确诊 COVID-19 患者提供护理的澳大利亚医疗保健从业人员参与。收集了关于指南知晓度、相关性、易用性、可信度、价值、更新的重要性、使用情况以及优势和改进机会的信息。
共有 287 人完成了调查,2020 年 11 月进行了 10 次访谈。对工作组工作的认识程度很高,绝大多数受访者报告说指南非常或极其相关、易于使用、值得信赖且有价值。超过 50%的受访者曾使用指南来支持自己的临床决策;有 30%的人知道指南被用于其他临床实践。定性数据显示,在 COVID-19 大流行期间,大量的证据和意见让人无所适从,指南是一个可靠的、统一的循证建议来源;参与者认为指南在临床决策中建立了信心并提供了保证。还探讨了提高指南的知晓度和可及性的机会。
截至 2021 年 6 月,该指南已经发布并更新了 40 多次,包含 140 多项建议,并且正在用于指导临床决策。这项影响评估的结果将用于改进工作组和指南项目的流程和成果,并为未来的实用指南项目提供信息。