Implementatie van NHG-Standaarden: succes of probleem?

Grol, Richard; Braspenning, Jozé; Hulscher, Marlies; Wensing, Michel; Dijkstra, Rob

doi:10.1007/s12445-010-0012-9

Cited by 9 publications

(9 citation statements)

References 98 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We integrated multiple teaching strategies but found only a moderate effect on GP trainers’ laboratory-documented HIV testing behaviour. This concurs with other evidence on the difficulties of changing physicians’ behaviour [ 11 – 13 ]. GP trainers in our programme mentioned various barriers to and facilitators of new proactive HIV testing strategies recommended by guidelines [ 26 ].…”

Section: Discussionsupporting

confidence: 92%

“…There is no gold standard for successful implementation of new recommendations in evidence-based guidelines [ 11 ]. It is recommended that educational strategies should be interactive and include multiple teaching strategies, for example, group discussions about evidence and setting quality improvement targets [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…The Dutch STI guidelines for GPs were released in 2013 [ 9 , 10 ]. Educational strategies are often the first step in the implementation of evidence-based practice guidelines among GPs [ 11 ]. However, convincing GPs to follow new recommendations is a complex task [ 11 – 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…Educational strategies are often the first step in the implementation of evidence-based practice guidelines among GPs [ 11 ]. However, convincing GPs to follow new recommendations is a complex task [ 11 – 13 ]. Educational strategies are more effective in inducing behavioural change if they involve interactive training programmes that use multiple teaching strategies [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Development and evaluation of a blended educational programme for general practitioners’ trainers to stimulate proactive HIV testing

et al. 2018

View full text Add to dashboard Cite

BackgroundIn the Netherlands, a substantial proportion of newly diagnosed HIV patients present late for care, therefore, we investigated the effectiveness of a blended educational programme for trainers of GPs designed to stimulate proactive HIV testing.MethodsGP trainers at the Academic Medical Center in Amsterdam were invited to participate in a two days training programme incorporating evidence-based practice guidelines and multiple teaching strategies, including interactive lectures, discussion groups, e-learning and quality improvement targets. The GP trainers completed questionnaires before and after the programme to evaluate the effect of the programme. We also used six-monthly cumulative laboratory data from 2010 to 2015 to compare the participating GPs’ HIV tests to the general trend in testing among non-participating GPs.Results150 GP trainers attended the first session, and 74 completed the questionnaires for both sessions. GPs median score on achieving their quality improvement targets was high and the quality of the programme highly appreciated. Between 2010 and 2013, the mean annual number of laboratory-documented HIV tests decreased by 9.1% in the 624 GPs in the control group, and by 13.0% for 11 GPs in the intervention group. After the programme, the annual decreases were 2.3% and 1.8%, respectively. Before the programme, the GPs in the intervention group had 50% more laboratory-documented HIV tests than GPs in the control group. After the programme, GPs in the intervention group had twice as many laboratory-documented HIV tests as the controls.ConclusionsWe provided a detailed description of a programme based on educational and clinical evidence. We could not retrieve laboratory-documented HIV testing data for the majority of GPs in both the intervention and control groups. Therefore, the limited results should be interpreted with caution as our findings may not be representative of all participants. The blended educational programme appears to have stabilized – at a higher level – the initially stronger downward trend in testing for 11 GPs undergoing the intervention, indicating that the programme may have had an impact on their HIV testing behaviour.Electronic supplementary materialThe online version of this article (10.1186/s12875-018-0723-8) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Development and evaluation of a blended educational programme for general practitioners’ trainers to stimulate proactive HIV testing

et al. 2018

View full text Add to dashboard Cite

show abstract

“…GPs should be educated about the context of pre-test information and how to offer an HIV test during IC-guided testing, for example, by using an opt-out approach (‘You will be tested unless you decline’). Many GPs use educational tools to keep up to date and these are often the first step in an implementation or change process [38]. We recommend that IC-guided testing should be better integrated in GPs’ future guidelines and that education strategies be developed to facilitate its implementation in daily practice.…”

Section: Resultsmentioning

confidence: 99%

The need to scale up HIV indicator condition-guided testing for early case-finding: a case-control study in primary care

et al. 2016

View full text Add to dashboard Cite

BackgroundEuropean guidelines recommend offering an HIV test to individuals who display HIV indicator conditions (ICs). We aimed to investigate the incidence of ICs in primary care reported in medical records prior to HIV diagnosis.MethodsWe did a cross-sectional search in an electronic general practice database using a matched case-control design to identify which predefined ICs registered by Dutch GPs were most associated with an HIV-positive status prior to the time of diagnosis.ResultsWe included 224 HIV cases diagnosed from 2009 to 2013, which were matched with 2,193 controls. Almost two thirds (n = 136, 60.7%) of cases were diagnosed with one or more ICs in the period up to five years prior to the index date compared to 18.7% (n = 411) of controls. Cases were more likely to have an IC than controls: in the one year prior to the index date, the odds ratio (OR) for at least one condition was 11.7 (95% CI: 8.3 to 16.4). No significant differences were seen in the strength of the association between HIV diagnosis and ICs when comparing genders, age groups or urbanisation levels. There is no indication that subgroups require a different testing strategy.ConclusionsOur study shows that there are opportunities for IC-guided testing in primary care. We recommend that IC-guided testing be more integrated in GPs’ future guidelines and that education strategies be used to facilitate its implementation in daily practice.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-016-0556-2) contains supplementary material, which is available to authorized users.

show abstract