尽量减少不必要的 proBNP 血液测试:在一般实践中对弹出式表格实施的评估
Morvarid Sophia Esmaeilzadeh1, Anna Elise Engell1, Henrik Løvendahl Jørgensen1,2
1Department of Clinical Biochemistry, Copenhagen University Hospital, Hvidovre, Denmark.
Scandinavian journal of primary health care
|October 3, 2024
概括
一个弹出的形式减少了proBNP血液测试由全科医生订购的60%. 这项干预措施改善了适当的测试订单,确保了更好的患者护理和心脏诊断资源配置.
科学领域:
- 临床诊断 临床诊断 临床诊断
- 生物化学 生化学
- 医疗信息学 医疗信息学
背景情况:
- 亲脑天然尿素 (proBNP) 测试对于诊断心力衰竭至关重要.
- 在2016年至2021年期间,一般医生 (GPs) 的proBNP测试订单的增加趋势被观察到.
- 丹麦心脏病学会的指导方针建议对proBNP测试进行特定的指示.
研究的目的:
- 评估强制性电子弹出式表单对GP proBNP测试订购模式的影响.
- 评估干预是否使proBNP测试订单与当前的临床指南保持一致.
- 为了分析proBNP测试量和患者干预后结果的变化.
主要方法:
- 采用了后续研究设计,比较了干预前后的proBNP测试订单.
- 2022年3月,一个强制性的弹出窗口表格被整合到电子请求系统 (WebReq) 中.
- 分析了丹麦首都地区528名全科医生的数据 (2020-2023年1月),其中包括83576个BNP结果.
主要成果:
- 在干预后,一般医生订购的每月平均proBNP测试减少了60%.
- 最显著的减少发生在大量测试者中 (每1000个生物化学测试中≥3个测试).
- 在高体积组中,中位数proBNP水平略有增加,从12.1到13.5 pmol/L (p<0.0001),表明更适当的利用.
结论:
- 强制性弹出式表格的实施有效地减少了全科医生的proBNP测试请求.
- 干预成功引导一般医生按照既定的指导方针订购proBNP测试.
- 这种方法证明了优化初级保健诊断测试利用的成功策略.
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