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在秘鲁,针对非传染性疾病,在初级卫生保健环境中实施一种多参数即时检测设备的干预措施的共同制定过程。

Co-creation process of an intervention to implement a multiparameter point-of-care testing device in a primary healthcare setting for non-communicable diseases in Peru.

机构信息

CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.

FIND, Geneva, Switzerland.

出版信息

BMC Health Serv Res. 2024 Mar 29;24(1):401. doi: 10.1186/s12913-024-10809-3.

Abstract

BACKGROUND

Point-of-care testing (POCT) devices are diagnostic tools that can provide quick and accurate results within minutes, making them suitable for diagnosing non-communicable diseases (NCDs). However, these devices are not widely implemented in healthcare systems and for this reason is relevant to understand the implementation process.

AIM

To describe the process and define a strategy to implement a multiparameter POCT device for diagnosing and managing NCDs in one region of Peru.

METHODS

A descriptive and non-experimental study, using the participatory methodologies of co-creation process. It was conducted in one region of Peru (Tumbes) to design an intervention for implementing a multiparameter POCT device. Two co-creation sessions were conducted involving five groups: community members, primary healthcare workers, these groups in both rural and urban settings, and regional decision-makers. These sessions included activities to understand patient journeys in receiving care for NCDs, identify facilitators and barriers to POCT devices usage, and define an implementation strategy for POCT devices in both rural and urban settings of Tumbes. The research team analysed the data and summarized key topics for discussion after each session.

RESULTS

A total of 78 participants were enrolled across the five groups. Among community members: 22.2% had only diabetes, 24.1% had only hypertension, and 18.5% had both diagnoses. In the patient journey, community members mentioned that it took at least three days to receive a diagnosis and treatment for an NCD. Most of the participants agreed that the POCT devices would be beneficial for their communities, but they also identified some concerns. The strategy for POCT devices implementation included healthcare workers training, POCT devices must be placed in the laboratory area and must be able to perform tests for glucose, glycated haemoglobin, cholesterol, and creatinine. Advertising about POCT devices should be displayed at the healthcare centres and the municipality using billboards and flyers.

CONCLUSIONS

The co-creation process was useful to develop strategies for the implementation of multiparameter POCT devices for NCDs, involving the participation of different groups of stakeholders guided by moderators in both, rural and urban, settings in Peru.

摘要

背景

即时检测(POCT)设备是一种诊断工具,可在数分钟内提供快速准确的结果,非常适合诊断非传染性疾病(NCD)。然而,这些设备并未在医疗保健系统中广泛实施,因此了解其实施过程很有必要。

目的

描述在秘鲁一个地区实施用于诊断和管理 NCD 的多参数 POCT 设备的过程并制定实施策略。

方法

采用共创过程的参与式方法,进行了一项描述性和非实验性研究。该研究在秘鲁的一个地区(通贝斯)进行,旨在设计一项干预措施,以实施用于诊断和管理 NCD 的多参数 POCT 设备。开展了两次共创会议,涉及五个小组:社区成员、初级保健工作者、农村和城市环境中的这两个群体以及区域决策者。这些会议包括了解患者在接受 NCD 治疗过程中的经历、确定 POCT 设备使用的促进因素和障碍以及为通贝斯的农村和城市环境制定 POCT 设备实施策略的活动。研究团队在每次会议后分析数据并总结关键讨论主题。

结果

五个小组共纳入 78 名参与者。在社区成员中:22.2%仅有糖尿病,24.1%仅有高血压,18.5%两种诊断均有。在患者就诊经历中,社区成员表示,至少需要三天才能获得 NCD 的诊断和治疗。大多数参与者认为 POCT 设备对他们的社区有益,但也提出了一些担忧。POCT 设备实施策略包括对医护人员进行培训,POCT 设备必须放置在实验室区域,并能够进行血糖、糖化血红蛋白、胆固醇和肌酐检测。应当在医疗机构和市政府所在地使用广告牌和传单来宣传 POCT 设备。

结论

共创过程有助于制定在秘鲁农村和城市环境中实施多参数 POCT 设备用于 NCD 的策略,该过程涉及不同利益相关者群体的参与,并由主持人引导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e659/10981306/429b596e67f6/12913_2024_10809_Fig1_HTML.jpg

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