Choosing Wisely Campaign: Perspectives of Emergency Physicians of Pakistan

S. Ghauri, T. Abbasi, A. Khan, K. Mustafa, Faiza Shah, Dania Dawood
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Abstract

Objective: To assess perspectives of Pakistani emergency physicians regarding the American College of Emergency Physician’s Choosing Wisely Recommendations Methodology: Physicians working in the emergency department of three hospitals in Pakistan were included in this cross-sectional study. The interviewer-administered study questionnaire was formulated as per ACEPs Choosing Wisely recommendations for emergency physicians. The study questionnaire was validated, and informed written consent was obtained from all the study participants. Ethical approval was taken from the ethical review board of Poonch Medical College, Azad Kashmir, Pakistan. Data was analyzed by SPSS v23.0 and was presented in tables and charts. Results: Out of 70 emergency physicians, 63 responded and were included in the study (response rate = 90%). More than two-thirds of the physicians (68.3%) had never heard of Choosing Wisely recommendations and more than three-quarters (77.8%) had never discussed it with anybody. Eighteen physicians (28.6%) who knew about it had heard about it from their colleagues. Physician’s beliefs about Choosing Wisely campaign were as follows: 28.6% believed it will strongly increase patient safety, 39.7% believed it will somewhat increase the quality of patient care, and 57.1% believed it will have no impact on physician’s salary. The most important reason (38.1%) behind ordering a low-value investigation is due to fulfillment of patients request. Conclusion: This study identified emergency physicians’ low level of familiarity with Choosing Wisely recommendations. With the ever-increasing national health cost, issues of drug resistance and hospital acquired infections, it is important to optimize the health care and expenditure. Educating physicians and patients with Choosing Wisely recommendations may decrease unnecessary investigations and procedures, over use of antibiotics and improve doctor-patient communication.
明智选择运动:巴基斯坦急诊医生的观点
目的:评估巴基斯坦急诊医生对美国急诊医师学会“明智选择建议”的看法。方法:在巴基斯坦三家医院急诊科工作的医生参与了这项横断面研究。访谈者管理的研究问卷是根据ACEPs对急诊医生的明智选择建议制定的。对研究问卷进行验证,并获得所有研究参与者的知情书面同意。伦理批准来自巴基斯坦阿扎德克什米尔的Poonch医学院伦理审查委员会。数据采用SPSS v23.0统计软件进行分析,并以表格形式呈现。结果:在70名急诊医生中,63名回应并纳入研究(回应率= 90%)。超过三分之二(68.3%)的医生从未听说过明智选择的建议,超过四分之三(77.8%)的医生从未与任何人讨论过。有18名医生(28.6%)从同事处听说过此病。医生对“明智选择”运动的看法如下:28.6%的人认为它将大大提高患者的安全,39.7%的人认为它将在一定程度上提高患者的护理质量,57.1%的人认为它不会对医生的工资产生影响。低价值检查的最主要原因(38.1%)是满足了患者的要求。结论:本研究发现急诊医生对明智选择建议的熟悉程度较低。随着国民医疗费用的不断增加、耐药性和医院获得性感染等问题的出现,优化医疗服务和医疗支出显得尤为重要。对医生和患者进行明智选择建议的教育,可以减少不必要的检查和程序,减少抗生素的过度使用,并改善医患沟通。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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