■评估对临床实践指南(CPG)的遵守情况,并探讨巴林初级保健医生(PCP)实施指南的障碍。
一项横断面研究是在巴林20个随机选择的公共部门初级保健中心工作的医生中进行的一项在线调查。私营部门医生和家庭医学居民被排除在外。结果措施是评估遵守CPG的程度,描述与工作角色相关的结果,性别,正规培训的水平,和多年的工作经验,并调查坚持CPG的障碍。
■受试者为149个PCP(顾问,专家,和全科医生)在政府初级保健中心工作。绝大多数(98.0%)报告说他们在日常实践中实施了CPG。实施的最常见原因(79.2%)是CPG是基于证据的。实施最多的指南涉及糖尿病(91.3%),高血压(81.2%),和高脂血症(69.8%)。实施最少的是妇女筛查(38.9%)和产后护理(45.6%)。正式医疗培训的水平与预防保健CPG的实施有关,产前和产后护理,以及儿童和妇女筛查(p<0.05)。高血压和支气管哮喘指南更多的是由男医生实施(p<0.05),而女医生在产前和产后护理上更多地遵循CPG,妇女和儿童筛查(p<0.05)。医生报告的主要障碍是他们希望在应用CPG之前更多地了解CPG(平均值±SD=3.8±0.9)。经理或董事对CPG的应用不合作的看法与多年的经验(p=0.008)和医生的职位(p=0.028)有关。全科医生更有可能将患者的不合作视为障碍(p=0.025)。
■巴林的大多数PCP在日常实践中都遵守CPG,遇到的障碍最小。识别和解决障碍可以帮助制定统一和标准化的指南,从而提高患者管理的一致性。尽量减少医疗错误,并节约资源。
UNASSIGNED: To assess the adherence to clinical practice
guidelines (CPGs) and explore the barriers to their implementation among primary care physicians (PCPs) in Bahrain.
UNASSIGNED: A cross-sectional study was conducted using an online survey among physicians working in 20 randomly selected public sector primary health centers in Bahrain. Private-sector physicians and family medicine residents were excluded. Outcome measures were assessing the extent of adherence to CPGs, describing the results in association with work roles, gender, level of formal training, and years of working experience, and investigating the barriers to adhering to CPGs.
UNASSIGNED: The subjects were 149 PCPs (consultants, specialists, and general practitioners) working in government primary health centers. The vast majority (98.0%) reported that they implemented CPGs in their daily practice. The most commonly cited reason (79.2%) for implementation was that the CPGs were evidence-based. The most implemented
guidelines pertained to diabetes (91.3%), hypertension (81.2%), and hyperlipidemia (69.8%). The least implemented ones were screening of women (38.9%) and postnatal care (45.6%). The level of formal medical training was associated with the implementation of CPGs on preventive care, antenatal and postnatal care, and children and women screening (p < 0.05). Hypertension and bronchial asthma
guidelines were implemented more by male physicians (p < 0.05) while female physicians were more adherent to CPGs on antenatal and postnatal care, and women and child screening (p < 0.05). The main barrier reported by the physicians was that they wished to know more about CPGs before applying them (mean ± SD = 3.8 ± 0.9). The perception that managers or directors are non-cooperative towards the application of CPGs was associated with years of experience (p = 0.008) and the position of the physician (p = 0.028). General practitioners were more likely to consider non-cooperation from patients as a barrier (p = 0.025).
UNASSIGNED: Most PCPs in Bahrain are adherent to CPGs in their daily practice and encounter minimal barriers. Identifying and resolving barriers can help develop unified and standardized
guidelines that promote better consistency in patient management, minimize medical errors, and conserve resources.