量身定制的干预措施,以解决实践的决定因素
Sheena McHugh1, Fiona Riordan2, Aoife O'Mahony1
1School of Public Health, University College Cork, Cork, Ireland.
The Cochrane database of systematic reviews
|February 27, 2026
概括
量身定制的实施策略可能会改善医疗保健专业的实践. 这份对79项研究的最新审查发现,与非定制方法相比,定制策略可能会带来轻微的改善.
科学领域:
- 医疗保健实施科学 医疗保健实施科学
- 改善临床实践的改善
- 基于证据的医学 基于证据的医学
背景情况:
- 建议采用量身定制的实施策略,通过解决特定障碍来加强医疗保健专业的实践.
- 本次审查是2015年出版物的更新,重点关注定制策略的有效性.
研究的目的:
- 评估量身定制的实施策略与非量身定制或没有策略对医疗保健专业实践的影响.
- 探索理论,证据,利益相关者投入和国家收入水平对定制有效性的影响的次要目标.
主要方法:
- 搜索了多个数据库 (CENTRAL,MEDLINE,Embase) 和从2014年到2024年3月的试验注册.
- 包括随机对照试验 (RCT),比较量身定制和非量身定制的策略,不包括仅针对患者的行为改变研究.
- 使用随机效应模型进行了元分析,并使用Cochrane RoB 2工具评估了偏差风险.
主要成果:
- 包括79项研究 (52项新研究),其中35项比较量身定制与非量身定制策略 (5015名专业人士),44项比较量身定制与没有策略 (20615名专业人士).
- 与非定制策略相比,定制策略可能会在专业实践中略有改善 (OR 1.49,95% CI 1.26至1.75;中等确定性证据).
- 与没有策略相比,量身定制的策略显示了1.34 (95% CI 1.17 到 1.53) 的合并几率比率.
结论:
- 尽管包括的研究增加了,但主要发现与之前的审查一致.
- 量身定制的实施策略可能会使医疗保健专业的实践略有改善.
- 进一步的研究可能会完善对各种环境中影响定制有效性的因素的理解.
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