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Titolo:
Adherence to guidelines on cervical cancer screening in general practice: programme elements of successful implementation
Autore:
Hermens, RPMG; Hak, E; Huscher, MEJL; Braspenning, JCC; Grol, RPTM;
Indirizzi:
Univ Nijmegen, Med Ctr, Ctr Qual Care Res WOk, NL-6500 HB Nijmegen, Netherlands Univ Nijmegen Nijmegen Netherlands NL-6500 HB 0 HB Nijmegen, Netherlands Univ Maastricht, Maastricht, Netherlands Univ Maastricht Maastricht Netherlands stricht, Maastricht, Netherlands Univ Utrecht, Med Ctr, Julius Ctr Gen Practice & Patient Oriented Res, Utrecht, Netherlands Univ Utrecht Utrecht Netherlands ent Oriented Res, Utrecht, Netherlands
Titolo Testata:
BRITISH JOURNAL OF GENERAL PRACTICE
fascicolo: 472, volume: 51, anno: 2001,
pagine: 897 - 903
SICI:
0960-1643(200111)51:472<897:ATGOCC>2.0.ZU;2-E
Fonte:
ISI
Lingua:
ENG
Soggetto:
PRIMARY-CARE; CONTROLLED TRIAL; PREVENTION; INTERVENTIONS; STRATEGY;
Keywords:
guideline adherence; preventive health services; cervical cancer; screening;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
28
Recensione:
Indirizzi per estratti:
Indirizzo: Hermens, RPMG Univ Nijmegen, Med Ctr, Ctr Qual Care Res WOk, POB 9101, NL-6500 HB Nijmegen, Netherlands Univ Nijmegen POB 9101 Nijmegen Netherlands NL-6500 HB ands
Citazione:
R.P.M.G. Hermens et al., "Adherence to guidelines on cervical cancer screening in general practice: programme elements of successful implementation", BR J GEN PR, 51(472), 2001, pp. 897-903

Abstract

Background: There is still only limited understanding of whether and why interventions to facilitate the implementation of guidelines for improving primary care are successful. It is therefore important to look inside the 'black box' of the intervention, to ascertain which elements work well or less well. Aim: To assess the associations of key elements of a nationwide multifaceted prevention programme with the successful implement tation of cervical screening guidelines in general practice. Design of study: A nationwide prospective cohort study. Setting. A random sample of one-third of all 4758 general practices in TheNetherlands (n = 1586). Method: General practitioners (GPs) in The Netherlands were exposed to a two-and-a-half-year nationwide multifaceted prevention programme to improve the adherence to national guidelines for cervical cancer screening. Adherence to guidelines at baseline and after the intervention and actual exposureto programme elements were assessed in the sample using self-administered questionnaires. Results. Both baseline and post-measurement questionnaires were returned by 988 practices (response rate = 62%). No mayor differences in baseline practice characteristics between study population, non-responders, and all Netherlands practices were observed. After the intervention all practices improved markedly (P<0.001) in their incorporation of nine out of 10 guideline indicators or effective cervical screening into practice. The most important elements for successful implementation were: specific software modules (odds ratios and 95% confidence intervals for all nine indicators ranged fromOR = 1.85 [95% CI = 1.24-2.77] to OR = 10.2 [95% CI = 7.38-14.1]); two or more 'practice visits' by outreach visitors (ORs and 95% CIs for six indicators ranged from OR = 1.46 [95% CI = 1.01-2.12] to OR = 2.35 [95% CI = 1.63-3.38]); and an educational programme for practice assistants (ORS and 95% CIs for four indicators ranged from OR = 1.37 [95% CI 1.00-1.92] to OR = 1.90 [95% CI = 125-2.88]). Conclusion; A multifaceted programme targeting GPs, including facilitatingsoftware modules, outreach visits, and educational sessions for PAs, contributes to the successful implementation of national guidelines for cervicalscreening.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/01/20 alle ore 08:20:17