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提高医生对预防医学指南的依从性。

Improving physician compliance with preventive medicine guidelines.

作者信息

Cohen D I, Littenberg B, Wetzel C, Neuhauser D

出版信息

Med Care. 1982 Oct;20(10):1040-5. doi: 10.1097/00005650-198210000-00006.

Abstract

Similar general medical outpatient clinics with randomly assigned patients were used to evaluate the effectiveness of a program that was to increase house staff compliance with preventive medicine guidelines. Two clinics were designated experimental and two served as controls. In the experimental clinics, age-specific checklists of all recommended preventive procedures (drawn from the Canadian Task Force report on The Periodic Health Examination and American Cancer Society guidelines) were appended to each patient's chart. In addition, house officers were presented with a series of weekly seminars dealing with issues in screening, as well as the specific recommendations included in the checklist. House officers in all four clinics were tested for their knowledge and attitudes toward the preventive program before and after the intervention. Counts of immunizations and mammograms performed and the total populations eligible for these procedures were determined for all four clinics. As predicted, test scores as well as mammography and immunization rates increased significantly (from 2-40 per cent) in the intervention clinics as compared with controls. We conclude that this intervention was clearly effective in the short run. However, follow-up studies will be necessary to determine whether the desired long-term effect has been achieved.

摘要

利用类似的普通医疗门诊诊所,将患者随机分配,以评估一项旨在提高住院医生对预防医学指南依从性的项目的有效性。指定两家诊所为实验组,两家作为对照组。在实验组诊所,将所有推荐的预防程序的年龄特异性检查表(摘自加拿大定期健康检查特别工作组报告和美国癌症协会指南)附在每位患者的病历上。此外,还为住院医生举办了一系列每周研讨会,内容涉及筛查问题以及检查表中包含的具体建议。在干预前后,对所有四家诊所的住院医生进行了关于预防项目的知识和态度测试。确定了所有四家诊所进行的免疫接种和乳房X光检查的次数以及符合这些程序的总人口数。正如预期的那样,与对照组相比,干预诊所的测试分数以及乳房X光检查和免疫接种率显著提高(从2%至40%)。我们得出结论,这种干预在短期内显然是有效的。然而,有必要进行后续研究以确定是否实现了预期的长期效果。

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