PDF(Pubmed)
Abstract：
OBJECTIVE: Despite being one of the most common types of the peripheral vertigo encountered in clinical practice, benign paroxysmal positional vertigo (BPPV) remains underdiagnosed and undertreated, even in affluent health care systems. The publication of fully updated clinical practice guidelines significantly facilitated the diagnosis and treatment of BPPV. This study evaluates the adoption of the guidelines in our clinical setting and reviews further recommendations for quality-of-care improvement.
METHODS: This retrospective cross-sectional survey included a total of 1155 adult patients diagnosed with BPPV at the biggest tertiary care center in the country during a 5-year period (2017-2021). The data for the first three years (2017-2020) and 919 patients were collected in full, and for the remaining 236 patients (2020-2021) only partially due to the disturbance in referrals caused by COVID-19 pandemic.
RESULTS: The familiarity with and adherence to the published clinical guidelines by physicians judged by patients\' charts and our health care database were overall unsatisfactory. The adherence varied from 0 to 40.5% in our sample. The recommendations for making the diagnosis and for repositioning procedure as first-line therapy were followed in only 20-30% of cases.
CONCLUSIONS: There are large opportunities for improvement in quality of care of BPPV patients. Apart from constant and systematic education at the primary health care level, the health care system may need to adopt more advanced measures of ensuring better adherence to guidelines and subsequent reduction in medical costs.
METHODS: This retrospective cross-sectional survey included a total of 1155 adult patients diagnosed with BPPV at the biggest tertiary care center in the country during a 5-year period (2017-2021). The data for the first three years (2017-2020) and 919 patients were collected in full, and for the remaining 236 patients (2020-2021) only partially due to the disturbance in referrals caused by COVID-19 pandemic.
RESULTS: The familiarity with and adherence to the published clinical guidelines by physicians judged by patients\' charts and our health care database were overall unsatisfactory. The adherence varied from 0 to 40.5% in our sample. The recommendations for making the diagnosis and for repositioning procedure as first-line therapy were followed in only 20-30% of cases.
CONCLUSIONS: There are large opportunities for improvement in quality of care of BPPV patients. Apart from constant and systematic education at the primary health care level, the health care system may need to adopt more advanced measures of ensuring better adherence to guidelines and subsequent reduction in medical costs.
摘要：
目的：尽管是临床实践中最常见的外周性眩晕类型之一，良性阵发性位置性眩晕（BPPV）仍未得到诊断和治疗，即使在富裕的医疗保健系统中。完全更新的临床实践指南的出版极大地促进了BPPV的诊断和治疗。这项研究评估了我们临床环境中指南的采用情况，并回顾了改善护理质量的进一步建议。
方法：这项回顾性横断面调查包括在5年期间（2017-2021年）在该国最大的三级护理中心诊断为BPPV的1155名成年患者。前三年（2017-2020年）和919名患者的数据全部收集，其余236名患者（2020-2021年）仅部分是由于COVID-19大流行对转诊的干扰。
结果：根据患者图表和我们的医疗保健数据库判断，医生对已发布的临床指南的熟悉程度和依从性总体上不能令人满意。在我们的样品中,粘附性从0变化到40.5%。只有20-30％的病例遵循了诊断和重新定位程序作为一线治疗的建议。
结论：BPPV患者的护理质量有很大的改善机会。除了在初级卫生保健一级进行持续和系统的教育之外，医疗保健系统可能需要采取更先进的措施，以确保更好地遵守指南并随后降低医疗成本。
方法：这项回顾性横断面调查包括在5年期间（2017-2021年）在该国最大的三级护理中心诊断为BPPV的1155名成年患者。前三年（2017-2020年）和919名患者的数据全部收集，其余236名患者（2020-2021年）仅部分是由于COVID-19大流行对转诊的干扰。
结果：根据患者图表和我们的医疗保健数据库判断，医生对已发布的临床指南的熟悉程度和依从性总体上不能令人满意。在我们的样品中,粘附性从0变化到40.5%。只有20-30％的病例遵循了诊断和重新定位程序作为一线治疗的建议。
结论：BPPV患者的护理质量有很大的改善机会。除了在初级卫生保健一级进行持续和系统的教育之外，医疗保健系统可能需要采取更先进的措施，以确保更好地遵守指南并随后降低医疗成本。
