背景:儿科医生通常是初级保健(PC)中儿童的第一联系点,但仍然认为他们的过敏知识存在差距。我们调查了欧洲医疗保健系统中儿科医生的自我感知知识差距和教育需求,以便未来的教育计划可以更好地支持PC中过敏服务的提供。
方法:自2023年2月至3月,EAACI初级保健儿科医生过敏教育需求工作组向照顾PC过敏问题儿童和青少年的儿科医生进行了一项跨国调查。使用5点Likert量表评估与问卷陈述的一致性水平。每个国家进行30项调查是纳入和统计分析的截止日期。
结果:在这项研究中,1991年的答复来自欧洲56个国家,210个答复来自每个国家的截止人数低于30人的国家。初级保健儿科医生(PCP)占受访者的74.4%。大多数(65.3%)与州或地区的卫生服务签约。61.7%的人了解其国家/地区的过敏转诊指南,但只有22.3%的人了解有关过敏的专职医疗人员的EAACI能力文件。总样本受访者与PCP的比较显示,52%和47%的受访者可以在其PC设施中进行过敏调查(主要是特异性IgE和皮肤点刺测试);67.6%和58.9%可以接受免疫疗法。分别。转诊给专科医生的主要障碍是考虑患者的病情可以在该PC设施中进行诊断和治疗,(分别为57.8%和63.6%)。转诊的主要原因是需要住院评估,对一线治疗有部分反应(55.4%和59.2%,47%和50.7%,分别)。学习和评估方法的偏好在传统方法(分别为45.7%和50.1%)和电子学习45.5%和44.9%之间相当平均。分别。全科医生(GP)接触过敏调查的机会最差(32.7%,p=.000)。总样本的大部分(91.9%)评估患有变应性病理的患者。868(43.6%)和1117(46.1%),分别作为本科生和研究生接受过敏培训[这些比例在PCP中更高(45%和59%),分别]。对变态反应学特别感兴趣的PCP作为研究生经历了更多的变态反应教学。全科医生作为本科生接受了最大量的过敏教学。根据临床表现识别过敏性疾病,受访者对湿疹/特应性皮炎(87.4%)和鼻炎/哮喘(86.2%)的管理最有信心,对过敏原免疫疗法(36.9%)和乳胶过敏(30.8%)最不自信。
结论:本研究探索PCP诊断的信心,管理,并推荐过敏患者,展示了过敏临床实践的知识差距和教育需求。它检测到迫切需要改进的领域,特别是在乳胶和过敏原免疫疗法方面。重要的是要确保传播过敏指南和支持EAACI文件,因为大多数PCP缺乏对它们的认识。这项调查使我们能够确定PCP的教育优先事项是什么,以及他们希望如何满足他们的要求。
BACKGROUND: Pediatricians are often the first point of contact for children in Primary Care (PC), but still perceive gaps in their allergy knowledge. We investigated self-perceived knowledge gaps and educational needs in pediatricians across healthcare systems in Europe so that future educational initiatives may better support the delivery of allergy services in PC.
METHODS: A multinational survey was circulated to pediatricians who care for children and adolescents with allergy problems in PC by the EAACI Allergy Educational Needs in Primary Care Pediatricians Task Force from February to March 2023. A 5-point Likert scale was used to assess the level of agreement with questionnaire statements. Thirty surveys per country were the cut-off for inclusion and statistical analysis.
RESULTS: In this study, 1991 respondents were obtained from 56 countries across Europe and 210 responses were from countries with a cut-off below 30 participants per country. Primary care pediatricians (PCPs) comprised 74.4% of the respondents. The majority (65.3%) were contracted to state or district health services. 61.7% had awareness of guidelines for onward allergy referral in their countries but only 22.3% were aware of the EAACI competencies document for allied health professionals for allergy. Total sample respondents versus PCPs showed 52% and 47% of them have access to allergy investigations in their PC facility (mainly specific IgE and skin prick tests); 67.6% and 58.9% have access to immunotherapy, respectively. The main barrier to referral to a specialist was a consideration that the patient\'s condition could be diagnosed and treated in this PC facility, (57.8% and 63.6% respectively). The main reasons for referral were the need for hospital assessment, and partial response to first-line treatment (55.4% and 59.2%, 47% and 50.7%, respectively). Learning and assessment methods preference was fairly equally divided between Traditional methods (45.7% and 50.1% respectively) and e-learning 45.5% and 44.9%, respectively. Generalist physicians (GPs) have the poorest access to allergy investigations (32.7%, p = .000). The majority of the total sample (91.9%) assess patients with allergic pathology. 868 (43.6%) and 1117 (46.1%), received allergy training as undergraduates and postgraduates respectively [these proportions in PCPs were higher (45% and 59%), respectively]. PCPs with a special interest in allergology experienced greater exposure to allergy teaching as postgraduates. GPs received the largest amount of allergy teaching as undergraduates. Identifying allergic disease based on clinical presentation, respondents felt most confident in the management of eczema/atopic dermatitis (87.4%) and rhinitis/asthma (86.2%), and least confident in allergen immunotherapy (36.9%) and latex allergy (30.8%).
CONCLUSIONS: This study exploring the confidence of PCPs to diagnose, manage, and refer patients with allergies, demonstrated knowledge gaps and educational needs for allergy clinical practice. It detects areas in need of urgent improvement especially in latex and allergen immunotherapy. It is important to ensure the dissemination of allergy guidelines and supporting EAACI documents since the majority of PCPs lack awareness of them. This survey has enabled us to identify what the educational priorities of PCPs are and how they would like to have them met.