Translating research into policy and practice in developing countries: a case study of magnesium sulphate for pre-eclampsia
Translating research into policy and practice in developing countries: a case study of magnesium sulphate for pre-eclampsia
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DOI：
10.1186/1472-6963-5-68
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发表时间：
2005-11-01
影响因子：
2.8
通讯作者：
Oxman, AD
中科院分区：
文献类型：
--
作者：
Aaserud, M;Lewin, S;Oxman, AD
背景：改善生殖健康的证据基础继续增长。然而，仍然令人关切的是，将这一证据转化为适当政策的工作是片面和缓慢的。对影响决策者和临床医生使用证据的因素知之甚少，特别是在发展中国家。本研究的目的是探讨可能影响翻译的随机对照试验（RCT）的结果转化为政策和实践在developing countries.Methods：最近出版的一个重要的RCT使用硫酸镁治疗先兆子痫提供了一个机会，探讨如何研究结果可能转化为政策。一系列的研究方法，包括调查，小组访谈和观察RCT合作者和世界卫生组织的药物信息官员，监管官员和产科医生在12个国家的调查，进行了识别障碍和促进知识translation.Results：它证明很难获得可靠的数据，在许多国家的可用性和常用药物的使用。实施关于使用硫酸镁治疗先兆子痫的RCT结果的感知障碍包括药物许可和可用性;临床指南不充分和执行不力;以及缺乏对政策变化的政治支持。然而，有显着的区域和国家差异的重要性，具体barriers.Conclusion：政策的变化，以确保广泛的可用性和使用硫酸镁是可变的和复杂的。在获得关于可得性和使用情况的信息方面存在困难，加上各种环境中存在的各种障碍，包括缺乏决策者的支持。这使得很难设想任何单一的干预策略，可用于促进吸收的研究结果，硫酸镁纳入整个研究设置的政策。因此，重要试验的发表可能不会对医疗保健产生研究人员所希望的影响。
Background: The evidence base for improving reproductive health continues to grow. However, concerns remain that the translation of this evidence into appropriate policies is partial and slow. Little is known about the factors affecting the use of evidence by policy makers and clinicians, particularly in developing countries. The objective of this study was to examine the factors that might affect the translation of randomised controlled trial (RCT) findings into policies and practice in developing countries.Methods: The recent publication of an important RCT on the use of magnesium sulphate to treat preeclampsia provided an opportunity to explore how research findings might be translated into policy. A range of research methods, including a survey, group interview and observations with RCT collaborators and a survey of WHO drug information officers, regulatory officials and obstetricians in 12 countries, were undertaken to identify barriers and facilitators to knowledge translation.Results: It proved difficult to obtain reliable data regarding the availability and use of commonly used drugs in many countries. The perceived barriers to implementing RCT findings regarding the use of magnesium sulphate for pre-eclampsia include drug licensing and availability; inadequate and poorly implemented clinical guidelines; and lack of political support for policy change. However, there were significant regional and national differences in the importance of specific barriers.Conclusion: The policy changes needed to ensure widespread availability and use of magnesium sulphate are variable and complex. Difficulties in obtaining information on availability and use are combined with the wide range of barriers across settings, including a lack of support from policy makers. This makes it difficult to envisage any single intervention strategy that might be used to promote the uptake of research findings on magnesium sulphate into policy across the study settings. The publication of important trials may therefore not have the impacts on health care that researchers hope for.