持续医疗教育干预可以改变儿科医生注意力缺陷/多动障碍的做法吗?
Peter S Jensen1,2, Tiffany W Brandt3, Christopher J Kratochvil4
1The REACH Institute, New York, New York.
JAACAP open
|February 25, 2026
概括
持续医学教育 (CME) 计划改善初级保健医生对注意力缺陷/多动障碍 (ADHD) 基于证据的实践的使用. 护理经理的支持增强了一些,但不是所有的实践变化.
科学领域:
- 医学教育 医学教育
- 儿科精神病学 儿科精神病学
- 改善临床实践的改善
背景情况:
- 初级保健临床医生 (PCC) 在实施基于证据的实践 (EBP) 治疗注意力缺陷/多动症 (ADHD) 时面临挑战.
- 持续医疗教育 (CME) 和护理经理 (CM) 的支持是改善初级保健机构ADHD诊断和治疗的潜在策略.
研究的目的:
- 评估一个为期6个月的CME计划对PCC采用ADHDEBP的影响.
- 确定随机分配的CM支持是否进一步增强了CME计划启动的实践变化.
主要方法:
- 47个PCC参加了为期3天的CME培训,其中一半获得了额外的CM支持.
- 在干预之前和之后对182例ADHD病例的图表审查评估了9个EBP变量.
- 混合效应回归分析检查了CME和CM支持对实践变化的影响.
主要成果:
- 在9个ADHDEBP变量中,有6个在CME后显著改善,包括诊断评级尺度和副作用监测.
- 对于三个EBP变量,CM支持显示了附加效益,但没有影响其他变量,例如随访频率或药物调整.
- 该CME计划对PCC的ADHDEBP实施产生了持续的积极影响.
结论:
- 密集的CME计划可以推动PCC对ADHD的临床实践的客观和持久改进.
- CM支持可以提高CME对特定实践行为的有效性,但需要进一步的研究来优化干预措施.
- 量身定制的教育和支持策略对于在ADHD管理中全面整合EBP至关重要.
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