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基层医疗中血液检测结果的传达:一项混合方法的系统评价

Communicating blood test results in primary care: a mixed-methods systematic review.

作者信息

Nankervis Helen, Huntley Alyson L, Whiting Penny, Hamilton William, Singh Hardeep, Dawson Sarah, O'Donnell Rachel, Sprackman Jane, Montague Anna Ferguson, Watson Jessica

机构信息

Population Health Sciences, Bristol Medical School, University of Bristol, Bristol.

University of Exeter, Exeter, UK.

出版信息

Br J Gen Pract. 2025 Mar 27;75(753):e222-e231. doi: 10.3399/BJGP.2024.0338. Print 2025 Apr.

Abstract

BACKGROUND

Online records access, including test results, was rolled out as part of changes to the GP contract in England in 2023. Blood test result communication is important for patient-centred care, patient safety, and primary care workload. Evidence is needed to ensure that test results are communicated safely and efficiently to patients in primary care.

AIM

To summarise existing evidence for blood test result communication between primary care providers and their patients and carers.

DESIGN AND SETTING

A mixed-methods systematic review was undertaken.

METHOD

MEDLINE, Embase, PsycInfo (Ovid), CINAHL (EBSCOhost), and the Cochrane Library were searched from January 2013-September 2023. Qualitative or quantitative studies that provided information on the communication of blood test results by primary care staff to adult patients and carers were eligible for inclusion.

RESULTS

There were 71 included studies, including 10 experimental studies and no randomised controlled trials. Study quality was mostly poor and risk of bias was high, partly owing to a lack of reported information. The studies found that patients want more information about their blood test results, particularly in terms of 'what next', and prefer results to be provided quickly. Electronic methods, such as online access or text messages, were generally well accepted but not by everyone, and not for all results. Clinicians' opinions were mixed as to whether online direct release of test results to patients was beneficial or could cause problems, such as increased patient anxiety and increased workload.

CONCLUSION

A range of evidence has been identified on patient and clinician preferences, and barriers and facilitators to test communication, which is particularly important in the current NHS context of a move towards patient online access.

摘要

背景

在线记录访问,包括检查结果,作为2023年英格兰全科医生合同变更的一部分推出。血液检查结果的沟通对于以患者为中心的护理、患者安全和初级护理工作量至关重要。需要证据来确保在初级护理中检查结果能够安全、高效地传达给患者。

目的

总结初级护理提供者与其患者及护理人员之间血液检查结果沟通的现有证据。

设计与设置

进行了一项混合方法的系统评价。

方法

检索了2013年1月至2023年9月期间的MEDLINE、Embase、PsycInfo(Ovid)、CINAHL(EBSCOhost)和Cochrane图书馆。纳入了提供初级护理人员向成年患者及护理人员传达血液检查结果信息的定性或定量研究。

结果

共纳入71项研究,包括10项实验研究,无随机对照试验。研究质量大多较差,偏倚风险较高,部分原因是报告信息不足。研究发现患者希望获得更多关于其血液检查结果的信息,特别是关于“下一步怎么办”,并且希望结果能尽快提供。电子方法,如在线访问或短信,通常被广泛接受,但并非所有人都接受,也并非适用于所有结果。临床医生对于向患者在线直接发布检查结果是否有益或是否会引发问题,如患者焦虑增加和工作量增加,意见不一。

结论

已确定了一系列关于患者和临床医生偏好以及检查结果沟通的障碍和促进因素的证据,这在当前国民保健服务(NHS)向患者在线访问转变的背景下尤为重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ef2/11961187/6194ea7beb6c/bjgpapr-2025-75-753-e222-1.jpg

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