Evidence-based medicine and headache patient management by general practitioners in Italy
Evidence-based medicine and headache patient management by general practitioners in Italy
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DOI：
10.1111/j.1468-2982.2005.00972.x
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发表时间：
2005-10-01
期刊：
影响因子：
4.9
通讯作者：
Angelillo, IF
中科院分区：
文献类型：
--
作者：
Bianco, A;Parente, MM;Angelillo, IF
这项研究调查了500名全科医生(GP)的随机样本中对循证医学(EBM)中使用的技术术语的认识以及治疗偏头痛患者的方式。邮寄的问卷包括关于全科医生的人口统计和实践特征；对循证医学的认识；关于偏头痛和循证医学的信息来源；以及患者的治疗行为。只有27.2%的全科医生同意需要临床试验来评估治疗的有效性，这种认识在那些从科学期刊或继续教育课程中了解偏头痛并参加循证医学课程的人中更高。对于三分之二的全科医生来说，残疾相当于疾病诊断，这种行为在那些同意需要临床试验来评估偏头痛预防或治疗方法的有效性，以及偏头痛的临床方法需要评估临床有效性的人中更为普遍，在那些治疗头痛患者数量较少的人中，在年龄较大的人中，在那些没有使用指南的人中。大多数(93.1%)的全科医生表示，将临床实践和最佳可用证据结合起来很重要，而且这种行为在那些同意偏头痛的临床方法需要临床疗效评估、需要临床试验来评估偏头痛预防或治疗的有效性的人以及参加循证医学课程的人中明显更常见。迫切需要关于循证医学的培训和继续教育方案以及全科医生头痛治疗指南。
The study explores the awareness of technical terms used in evidence-based medicine (EBM) and manner of treating patients with migraine among a random sample of 500 general practitioners (GPs). A mailed questionnaire included questions on GPs' demographics and practice characteristics; awareness of EBM; sources of information about migraine and EBM; and patient's treatment behaviour. Only 27.2% of GPs agreed that clinical trials are needed to evaluate the efficacy of treatments and this awareness was higher in those who learned about migraine from scientific journals or continuing education courses and who attended courses on EBM. For two-thirds of GPs, disability is equivalent to illness diagnosis, and this behaviour was more prevalent in those who agreed that clinical trials are needed to evaluate the efficacy of preventive or curative treatments of migraine and that the clinical approach to migraine required an evaluation of clinical effectiveness, in those who treated a lower number of headache patients, who were older, and in those who did not use guidelines. The majority (93.1%) of GPs indicated that it is important to integrate clinical practice and the best available evidence, and this behaviour was significantly more frequent in those who agreed that the clinical approach to migraine required a clinical effectiveness evaluation, that clinical trials are needed to evaluate the efficacy of preventive or curative treatments of migraine, and in those who attended courses on EBM. Training and continuing educational programmes on EBM and guidelines on treatments of headache for GPs are strongly needed.