目的:循证临床路径可以成为实施指南的有用工具。然而,临床路径的使用似乎存在障碍。本问卷调查的目的是评估“初级保健水平儿童和青少年超重/肥胖”临床路径的感知可用性,并确定促进和阻碍临床路径使用的因素。
方法:2020年1月,向奥地利的3,916名全科医生和470名儿科医生发送了在线问卷调查。对收集的数据进行描述性分析。
结果:共有148人参加了问卷调查(回复率为3.7%)。大多数受访者表示,总的来说,认为循证临床路径是有帮助的(90%),并利用它们(57%)。很少有受访者(9%)对奥地利开发的新临床路径有充分的了解。大多数受访者认为临床路径“初级保健儿童和青少年超重/肥胖”是一种有用的支持(60%),作为参考工作(72%)或作为证明他们对患者的治疗方法的促进者(68%)。然而,很大一部分受访者表示,临床路径不容易适用于日常实践。使用临床路径最常提到的三个障碍是缺乏时间资源,缺乏结构和财务激励。其他显示和访问选项(例如Procedure,个性化,集成到实践软件中)最常被引用为可能促进该途径使用的因素。
结论:尽管大多数受访者对使用临床路径“初级保健儿童和青少年超重/肥胖”抱有积极的期望,他们中的许多人仍然认为它在日常临床实践中的可用性很困难。改善循证临床路径使用的必要的下一步步骤似乎是:经济可行的设计,临床路径的容易获得和框架条件的创建,促进其在日常实践中的使用。
OBJECTIVE: Evidence-based clinical pathways can be a useful tool for guideline implementation. However, there seem to be barriers to the use of clinical pathways. The aim of the present questionnaire survey was to assess the perceived usability of the clinical pathway \"Overweight/obesity in children and adolescents at primary care level\" and to identify factors promoting and hindering the use of the clinical pathway.
METHODS: In January 2020, an online questionnaire survey was sent out to 3,916 general practitioners and 470 pediatricians in Austria. The data collected were analysed descriptively.
RESULTS: A total of 148 people took part in the questionnaire survey (response rate 3.7 %). The majority of respondents indicated that they, in general, perceive evidence-based clinical pathways as helpful (90 %) and also make use of them (57 %). Few respondents (9 %) felt well-informed about new clinical pathways developed in Austria. Most of the respondents considered the clinical pathway \"Overweight/obesity in children and adolescents at primary care level\" as a useful support (60 %), as a reference work (72 %) or as a facilitator for justifying their approach to their patients (68 %). However, a large proportion of the respondents stated that the clinical pathway is not easily applicable in everyday practice. The three most frequently cited barriers to using the clinical pathway were lack of time resources, lack of structures and lack of financial incentives. Other display and access options (e. g., individualisation, integration into practice software) were most frequently cited as factors that might promote the use of the pathway.
CONCLUSIONS: Although the majority of the respondents had positive expectations regarding the use of the clinical pathway \"Overweight/obesity in children and adolescents at primary care level\", many of them still perceived its usability in everyday clinical practice as difficult. The necessary next steps to improve the use of evidence-based clinical pathways seem to be: an economic and practicable design, easy accessibility of clinical pathways and the creation of framework conditions that facilitate their use in everyday practice.