在一般实践中认证的临床影响:一个务实的随机对照研究
Line B Pedersen1,2, Merethe K Andersen1, Sonja Wehberg1
1The Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
Family practice
|September 19, 2024
概括
在丹麦通用诊所的认证减少了药物使用和多药. 这种质量改善策略显示了小但显著的行为变化,尽管需要进一步的成本效益研究.
科学领域:
- 初级保健研究研究初级保健研究
- 医疗保健服务研究 医疗服务研究
- 提高质量 提高质量
背景情况:
- 在全球范围内,认证被广泛用于在一般实践中提高质量.
- 关于认证计划临床影响的强有力的证据仍然有限.
研究的目的:
- 评估丹麦通用实践中强制性国家认证计划的临床影响.
- 评估认证对药物使用和其他关键临床指标的影响.
主要方法:
- 实用随机对照试验涉及丹麦的一般实践.
- 在2016年 (干预) 或2018年 (控制) 随机认证的实践.
- 从基线 (2014年) 到随访 (2017年) 的赎回药物,多药房,NSAID使用,睡眠药物,预防性访问,年度控制,精神计量和死亡率的比较变化.
主要成果:
- 认证显著减少了赎回药物的数量.
- 认证也导致了多药的显著减少.
- 对于其他次要结果,没有观察到统计学意义上的影响.
结论:
- 这是第一个随机研究,证明了认证对减少初级保健中药物使用和多药物的影响.
- 认证可以影响提供者的行为,但观察到的效应是适度和具体的.
- 建议进一步研究认证计划的成本效益.
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