Clet Estelle, Leblanc Pierre, Alla François, Cohidon Christine
Prevention Department, University Hospital Centre Bordeaux Division of Public Health, Bordeaux, France
I-prev/PHARES (INSERM U1219), Université de Bordeaux, Bordeaux, France.
BJGP Open. 2024 Oct 29;8(3). doi: 10.3399/BJGPO.2023.0141. Print 2024 Oct.
The global burden of non-communicable diseases is increasing and the need for prevention is huge. Policies have yet to produce results and prevention indicators remain low. Primary care (PC) represents an opportunity to optimise the practice of prevention, but GPs are coming up against barriers that are holding back their prevention practices.
To identify the barriers and facilitators for the implementation of routine prevention practices in PC.
DESIGN & SETTING: This study is an international overview of reviews focusing on the integration of prevention in PC settings.
The search was conducted in July 2022 using MEDLINE, Embase, Web of Science, and the Cochrane Database of Systematic Reviews. Included reviews are systematic reviews or scoping reviews adopting a systematic approach.
The 35 reviews included identify multiple barriers and facilitators related to the integration of prevention in PC. These factors are heterogeneous with regard to their source (the patient, the professional, and the health system) and their level of action (individual, organisational, or contextual). The results show the need to organise PC at the professional level (for example, in training), at the local level (for example, the information system), and at the political level (for example, the unclear definition of the role of professionals).
The factors influencing the integration of prevention in PC are multiple and act at different levels (individual, organisational, and health-system level). Organisation factors play a major role and seem to be a means of overcoming the difficulties encountered by healthcare professionals in developing preventive practices.
非传染性疾病的全球负担正在增加，预防需求巨大。相关政策尚未产生成效，预防指标仍然很低。初级保健（PC）是优化预防实践的一个契机，但全科医生（GPs）面临着阻碍其预防实践的障碍。
确定在初级保健中实施常规预防实践的障碍和促进因素。
本研究是一项关于将预防纳入初级保健环境的综述的国际概述。
2022年7月使用MEDLINE、Embase、科学引文索引和Cochrane系统评价数据库进行检索。纳入的综述为采用系统方法的系统评价或范围综述。
纳入的35篇综述确定了与将预防纳入初级保健相关的多个障碍和促进因素。这些因素在来源（患者、专业人员和卫生系统）及其作用层面（个人、组织或背景）方面具有异质性。结果表明，需要在专业层面（如培训方面）、地方层面（如信息系统方面）和政策层面（如专业人员角色定义不明确方面）对初级保健进行组织。
影响将预防纳入初级保健的因素是多方面的，且在不同层面（个人、组织和卫生系统层面）发挥作用。组织因素起着主要作用，似乎是克服医疗保健专业人员在开展预防实践中遇到的困难的一种手段。
