Intra-articular knee injections in patients with primary osteoarthritis in a tertiary clinical setting: a best practice implementation project.

IF 2.7 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Mahmut Enes Kayaalp, Hassan Tarek Hakam, Jitka Klugarová, Miloslav Klugar, Tina Poklepović Peričić, Małgorzata M Bała, Roland Becker, Robert Prill
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引用次数: 0

Abstract

Aims: This project aimed to improve physicians' adherence to evidence-based practices regarding the selection and administration of intra-articular knee injections for patients with osteoarthritis. The project also aimed to empower patients by increasing their awareness of these evidence-based practices.

Introduction: In the management of knee osteoarthritis, intra-articular injections are commonly used when initial treatments prove inadequate. However, issues such as patients' demand for rapid relief and variability in physicians' familiarity with optimal practices often lead to suboptimal treatment decisions and potential adverse outcomes.

Methods: This project followed the JBI Evidence Implementation Framework, which is grounded in an audit, feedback, and re-audit process. Initially, physicians were surveyed on the topic under consideration, and hospital records were reviewed. Subsequently, targeted interventions were implemented, including briefings and the distribution of informative flyers.

Results: The baseline audit indicated low adherence with all audit criteria. Various parameters, such as adherence to best clinical practices, informed decision-making by patients, and the recommendation of alternative treatment modalities, were significantly lacking. Following the interventions, substantial improvements were observed, including higher rates of adherence to best clinical practices by physicians for multiple criteria, such as stepwise referral to conservative therapy options and the content of intra-articular injections.

Conclusions: Adherence to best clinical practices can be improved through educational briefings for physicians on the most current evidence-based treatment practices for injectable substances in knee osteoarthritis. The active engagement of patients, facilitated by informative flyers and physician assistance, contributed to better involvement in their treatment choices. However, the participation of health care institutions and providers as well as lifelong education practices may be necessary for more comprehensive and sustainable changes.

Spanish abstract: http://links.lww.com/IJEBH/A277.

在三级临床环境中对原发性骨关节炎患者进行膝关节内注射:最佳实践实施项目。
目的:该项目旨在提高医生对骨关节炎患者选择和实施膝关节内注射的循证实践的依从性。该项目还旨在提高患者对这些循证实践的认识,从而增强患者的能力:在膝关节骨性关节炎的治疗中,当初始治疗被证明效果不佳时,通常会使用关节内注射。然而,患者要求快速缓解症状以及医生对最佳治疗方法的熟悉程度参差不齐等问题往往会导致治疗决策不理想和潜在的不良后果:该项目遵循 JBI 证据实施框架,该框架以审计、反馈和再审计流程为基础。首先,对医生进行所考虑主题的调查,并审查医院记录。随后,实施了有针对性的干预措施,包括举办简报会和散发宣传单:基线审计表明,所有审计标准的遵守率都很低。各种参数,如最佳临床实践的遵守情况、患者的知情决策以及替代治疗方式的建议等,都明显不足。采取干预措施后,情况有了很大改善,包括医生在多个标准上对最佳临床实践的遵守率有所提高,如逐步转诊至保守治疗方案和关节内注射的内容:结论:通过向医生介绍膝骨关节炎注射物质的最新循证治疗方法,可以提高最佳临床实践的依从性。在信息传单和医生协助下,患者的积极参与有助于更好地参与治疗选择。然而,要想实现更全面和可持续的改变,医疗机构和医疗服务提供者的参与以及终身教育实践可能是必要的。西班牙文摘要:http://links.lww.com/IJEBH/A277。
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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来源期刊
CiteScore
3.20
自引率
13.00%
发文量
23
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