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优化基于证据的骨关节炎指南在初级保健中的实施:知识传播工具包的开发。

Optimising the implementation of evidence-based osteoarthritis guidelines in primary care: Development of a Knowledge Mobilisation Toolkit.

机构信息

Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire ST5 5BG, United Kingdom.

Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire ST5 5BG, United Kingdom; Haywood Academic Rheumatology Centre, Haywood Hospital, Midlands Partnership NHS Foundation Trust, Staffordshire, United Kingdom.

出版信息

Osteoarthritis Cartilage. 2024 May;32(5):612-629. doi: 10.1016/j.joca.2024.01.003. Epub 2024 Jan 17.

Abstract

OBJECTIVE

Implementing clinical guidelines for osteoarthritis (OA) in primary care is complex. Whilst international guidelines detail what best practice for OA looks like, little is known about how this is best implemented. Limited resources are available to guideline developers, practitioners, researchers, or the public to facilitate implementation. Set in the context of a larger research project which sought to understand the factors that influence knowledge mobilisation (KM) in implementation for OA guidelines, this study reports the development of a toolkit to optimise KM for the implementation of evidence-based OA guidelines in primary care.

DESIGN

Triangulation of three qualitative data sets was conducted, followed by a stakeholder consensus exercise. Public contributors were involved in dedicated meetings (n = 3) to inform the content, design, and KM plans for the toolkit.

RESULTS

From data triangulation, 53 key findings were identified, which were refined into 30 draft recommendation statements, within six domains: approaches to KM; the knowledge mobiliser role; understanding context; implementation planning; the nature of the intervention; and appealing to a range of priorities. Stakeholder voting (n = 27) demonstrated consensus with the recommendations and informed the wording of the final toolkit.

CONCLUSIONS

Factors that optimise KM for OA guideline implementation in primary care were identified. Empirical data, practice-based evidence, implementation practice, and stakeholder (including patient and public) engagement have informed a toolkit comprising several overarching principles of KM, which are suitable for use in primary care. Consideration of equitable access when implementing evidence-based OA care among diverse populations is recommended when using the toolkit. Further research is needed to evaluate the toolkit's utility and transferability.

摘要

目的

在初级保健中实施骨关节炎(OA)临床指南较为复杂。虽然国际指南详细说明了 OA 的最佳实践方法,但对于如何最好地实施这些方法知之甚少。指南制定者、从业者、研究人员或公众可利用的资源有限,难以促进实施。本研究以一项旨在了解影响 OA 指南实施知识转化(KM)的因素的更大研究项目为背景,报告了开发工具包以优化初级保健中基于证据的 OA 指南实施的 KM 的情况。

设计

对三个定性数据集进行了三角剖分,随后进行了利益相关者共识性研究。公众参与者参加了专门会议(n=3),为工具包的内容、设计和 KM 计划提供信息。

结果

通过数据三角剖分,确定了 53 项关键发现,这些发现经过提炼,形成了六个领域内的 30 项草案建议:KM 方法;知识转化者角色;了解背景;实施计划;干预的性质;以及满足一系列重点的需求。利益相关者投票(n=27)对建议达成了共识,并为最终工具包的措辞提供了信息。

结论

确定了优化 OA 指南在初级保健中实施的 KM 的因素。经验数据、基于实践的证据、实施实践以及利益相关者(包括患者和公众)的参与,为该工具包提供了一些 KM 的总体原则,这些原则适用于初级保健。建议在使用该工具包时,考虑在不同人群中实施基于证据的 OA 护理时公平获得护理的问题。需要进一步研究来评估该工具包的实用性和可转移性。

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