PDF(Pubmed)
Abstract：
Despite consistent international guidelines for osteoarthritis (OA) management, evidence-based treatments are underutilised. OA management programmes (OAMPs) are being implemented internationally to address this evidence-practice gap. An OAMP is defined as a \'model of evidence-based, non-surgical OA care that has been implemented in a real-world setting\'. Our objective is to identify, synthesise and appraise qualitative research identifying anticipated or experienced micro (individual/behavioural), meso (organisational) or macro (context/system) level barriers or facilitators to the implementation of primary or community care-based OAMPs. Five electronic databases will be searched for papers published between 2010 and 2021. Qualitative or mixed-methods studies that include qualitative data on the anticipated or experienced barriers or facilitators to the implementation of primary or community care-based OAMPs, from the perspective of service users or service providers, will be included. The review will be reported using the PRISMA and ENTREQ guidelines. A data extraction form will be used to provide details of the included studies. Data will be analysed and identified barriers and facilitators will be mapped onto an appropriate implementation framework, such as the Theoretical Domains Framework. The appropriate JBI critical appraisal tools will be used to assess methodological quality, while the GRADE-CERQual approach will be used to assess confidence in the findings. Translation of evidence-based guidelines into practice is challenging and reliant on the quality of implementation. By comparing and contrasting anticipated and experienced barriers, this review will determine the extent of congruence between the two, and provide valuable insights into the views and experiences of key stakeholders involved in the implementation of OAMPs. The mapping of identified barriers and facilitators to behaviour change theory will enhance the applicability and construct validity of our findings and will offer significant utility for future development and implementation of OAMPs. Registration: This protocol was registered with PROSPERO (CRD42021255698) on 15/07/21.
摘要：
尽管骨关节炎（OA）管理的国际指南一致，循证治疗未得到充分利用。正在国际上实施OA管理计划（OAMPs），以解决这一证据与实践之间的差距。OAMP被定义为基于证据的模型，非手术性OA护理已在现实世界中实施。我们的目标是确定,综合和评估定性研究，确定预期或经验的微观(个体/行为)，实施基于初级或社区护理的OAMP的中观（组织）或宏观（上下文/系统）级别的障碍或促进者。将搜索五个电子数据库，以查找2010年至2021年之间发表的论文。定性或混合方法研究，包括关于实施初级或社区护理OAMP的预期或经历的障碍或促进者的定性数据，从服务用户或服务提供商的角度来看，将包括在内。审查将使用PRISMA和ENTREQ指南进行报告。数据提取表将用于提供所包括研究的详细信息。将对数据进行分析，并将确定的障碍和促进者映射到适当的实施框架中，比如理论领域框架。适当的JBI关键评估工具将用于评估方法质量，而GRADE-CERQual方法将用于评估对调查结果的信心。将基于证据的准则转化为实践具有挑战性，并且依赖于实施质量。通过比较和对比预期障碍和经验障碍，这项审查将确定两者之间的一致性程度，并对参与实施OAMPs的主要利益相关者的观点和经验提供宝贵的见解。将已识别的障碍和促进者映射到行为变化理论将增强我们发现的适用性和构造有效性，并将为OAMPs的未来开发和实施提供重要的用途。注册：该协议于21年7月15日在PROSPERO（CRD42021255698）注册。
