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全科医生在临床实践中对证据的偏好、获取及使用:一项混合方法研究

GP preferences for, access to, and use of evidence in clinical practice: a mixed-methods study.

作者信息

O'Brien Emer, Walsh Aisling, Boland Fiona, Collins Claire, Harkins Velma, Smith Susan M, O'Herlihy Noirin, Clyne Barbara, Wallace Emma

机构信息

Department of General Practice, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland

Department of Public Health and Epidemiology, RCSI University of Medicine and Health Sciences, Dublin, Ireland.

出版信息

BJGP Open. 2023 Dec 19;7(4). doi: 10.3399/BJGPO.2023.0107. Print 2023 Dec.

Abstract

BACKGROUND

GPs aim to provide patient-centred care combining clinical evidence, clinical judgement, and patient priorities. Despite a recognition of the need to translate evidence to support patient care, barriers exist to the use of evidence in practice.

AIM

To ascertain the needs and preferences of GPs regarding evidence-based guidance to support patient care. The study also aimed to prioritise content and optimise structure and dissemination of future evidence-based guidance.

DESIGN & SETTING: This was a convergent parallel mixed-methods study in collaboration with the national GP professional body in the Republic of Ireland (Irish College of General Practitioners [ICGP]). Quantitative and qualitative findings were integrated at the interpretive level.

METHOD

A national GP survey was administered via the ICGP (December 2020) and seven GP focus groups were undertaken (April-May 2021).

RESULTS

Of 3496 GPs, a total of 509 responders (14.6%) completed the survey and 40 GP participants took part in focus groups. Prescribing updates, interpretation of test results, chronic disease management, and older person care were the preferred topics for future evidence-based guidance. GPs reported that they required rapid access to up-to-date and relevant evidence summaries online for use in clinical practice. Access to more comprehensive reviews for the purposes of continuing education and teaching was also a priority. Multimodal forms of dissemination were preferred to increase uptake of evidence in practice.

CONCLUSION

GPs indicated that rapid access to up-to-date, summarised evidence-based resources, available from their professional organisation, is preferred. Evidence should reflect the disease burden of the population and involve multifaceted dissemination approaches.

摘要

背景

全科医生旨在提供以患者为中心的医疗服务,将临床证据、临床判断和患者优先事项结合起来。尽管认识到需要转化证据以支持患者护理,但在实践中使用证据仍存在障碍。

目的

确定全科医生在基于证据的指导以支持患者护理方面的需求和偏好。该研究还旨在确定未来基于证据的指导的内容优先级,并优化其结构和传播方式。

设计与背景

这是一项与爱尔兰共和国国家全科医生专业机构(爱尔兰全科医生学院[ICGP])合作开展的收敛平行混合方法研究。定量和定性研究结果在解释层面进行整合。

方法

通过ICGP进行了一项全国性的全科医生调查(2020年12月),并开展了7个全科医生焦点小组(2021年4月至5月)。

结果

在3496名全科医生中,共有509名受访者(14.6%)完成了调查,40名全科医生参与了焦点小组。处方更新、检查结果解读、慢性病管理和老年人护理是未来基于证据的指导的首选主题。全科医生报告称,他们需要能够快速在线获取最新的相关证据摘要,以便在临床实践中使用。获取更全面的综述以用于继续教育和教学也是一个优先事项。多模式传播形式更受青睐,以提高实践中对证据的采纳率。

结论

全科医生表示,更倾向于能够快速从其专业组织获取最新的、总结性的循证资源。证据应反映人群的疾病负担,并采用多方面的传播方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d39/11176671/2da8d4dcbd32/bjgpopen-7-0107-f1.jpg

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