Background: Clinical decision support tools provide suggestions to support healthcare providers and clinicians, as they attend to patients. Clinicians use these tools to rapidly consult the evidence at the point of ca...Background: Clinical decision support tools provide suggestions to support healthcare providers and clinicians, as they attend to patients. Clinicians use these tools to rapidly consult the evidence at the point of care, a practice which has been found to reduce the time patients spend in hospitals, promote the quality of care and improve healthcare outcomes. Such tools include Medscape, VisualDx, Clinical Key, DynaMed, BMJ Best Practice and UpToDate. However, use of such tools has not yet been fully embraced in low-resource settings such as Uganda. Objective: This paper intends to collate data on the use and uptake of one such tool, UpToDate, which was provided at no cost to five medical schools in Uganda. Methods: Free access to UpToDate was granted through the IP addresses of five medical schools in Uganda in collaboration with Better Evidence at The Global Health Delivery Project at Harvard and Brigham and Women’s Hospital and Wolters Kluwer Health. Following the donation, medical librarians in the respective institutions conducted training sessions and created awareness of the tool. Usage data was aggregated, based on logins and content views, presented and analyzed using Excel tables and graphs. Results: The data shows similar trends in increased usage over the period of August 2022 to August 2023 across the five medical schools. The most common topics viewed, mode of access (using either the computer or the mobile app), total usage by institution, ratio of uses to eligible users by institution and ratio of uses to students by institution are shared. Conclusion: The study revealed that the tool was used by various user categories across the institutions with similar steady improved usage over the year. These results can inform the librarians as they encourage their respective institutions to continue using the tool to support uptake of point-of-care tools in clinical practice.展开更多
目的:探讨基于UpToDate的预警模式对乳腺癌术后接受AC-T方案化疗的患者的不良反应和疾病不确定感的影响。方法:纳入2020年10月—2022年10月甘肃省肿瘤医院收治的200例乳腺癌术后接受AC-T方案化疗的患者,随机分为对照组和观察组(各100例)...目的:探讨基于UpToDate的预警模式对乳腺癌术后接受AC-T方案化疗的患者的不良反应和疾病不确定感的影响。方法:纳入2020年10月—2022年10月甘肃省肿瘤医院收治的200例乳腺癌术后接受AC-T方案化疗的患者,随机分为对照组和观察组(各100例)。2组患者均接受手术治疗,术后接受AC-T方案化疗。治疗期间,对照组接受常规专科护理模式,观察组接受基于UpToDate的预警模式,持续干预3个月。比较2组患者的汉密顿尔焦虑量表(Hamilton anxiety scale,HAMA)、汉密顿尔抑郁量表(Hamilton depression rating scale,HAMD)、疾病不确定感量表(medical uncertainty inventory scale,MUIS)和欧洲癌症研究与治疗组织(European Organization for Research and Treatment of Cancer,EORTC)患者生活质量核心量表(EORTC quality of life questionnaire-core 30,EORTC-QLQ-C30)评分以及不良反应。结果:干预3个月后,观察组的HAMA、HAMD和MUIS评分分别为14.39±2.70、10.91±2.22和66.36±7.55分,均显著低于对照组(分别为17.76±4.15、15.62±3.34和76.23±10.31分),差异有统计学意义(P<0.05)。观察组的EORTC-QLQ-C30总生活质量评分为81.23±13.26分,高于对照组的73.69±8.45分(P<0.05);症状量表中,观察组的疲倦、恶性和呕吐以及疼痛评分分别为18.75±3.34、24.72±5.18和22.26±3.04分,均低于对照组(分别为29.03±6.07、35.07±8.15和28.31±5.16分)(P<0.05);单项测试中,观察组的失眠评分为18.65±3.37分,低于对照组的22.60±5.24分(P<0.05)。观察组的恶心和呕吐、食欲减退、腹痛腹泻以及血细胞减少发生率均低于对照组(P<0.05)。结论:基于UpToDate的预警模式可以改善乳腺癌术后化疗患者的心理状态,减少不良反应,降低疾病不确定感,提高生活质量。展开更多
文摘Background: Clinical decision support tools provide suggestions to support healthcare providers and clinicians, as they attend to patients. Clinicians use these tools to rapidly consult the evidence at the point of care, a practice which has been found to reduce the time patients spend in hospitals, promote the quality of care and improve healthcare outcomes. Such tools include Medscape, VisualDx, Clinical Key, DynaMed, BMJ Best Practice and UpToDate. However, use of such tools has not yet been fully embraced in low-resource settings such as Uganda. Objective: This paper intends to collate data on the use and uptake of one such tool, UpToDate, which was provided at no cost to five medical schools in Uganda. Methods: Free access to UpToDate was granted through the IP addresses of five medical schools in Uganda in collaboration with Better Evidence at The Global Health Delivery Project at Harvard and Brigham and Women’s Hospital and Wolters Kluwer Health. Following the donation, medical librarians in the respective institutions conducted training sessions and created awareness of the tool. Usage data was aggregated, based on logins and content views, presented and analyzed using Excel tables and graphs. Results: The data shows similar trends in increased usage over the period of August 2022 to August 2023 across the five medical schools. The most common topics viewed, mode of access (using either the computer or the mobile app), total usage by institution, ratio of uses to eligible users by institution and ratio of uses to students by institution are shared. Conclusion: The study revealed that the tool was used by various user categories across the institutions with similar steady improved usage over the year. These results can inform the librarians as they encourage their respective institutions to continue using the tool to support uptake of point-of-care tools in clinical practice.
文摘目的:探讨基于UpToDate的预警模式对乳腺癌术后接受AC-T方案化疗的患者的不良反应和疾病不确定感的影响。方法:纳入2020年10月—2022年10月甘肃省肿瘤医院收治的200例乳腺癌术后接受AC-T方案化疗的患者,随机分为对照组和观察组(各100例)。2组患者均接受手术治疗,术后接受AC-T方案化疗。治疗期间,对照组接受常规专科护理模式,观察组接受基于UpToDate的预警模式,持续干预3个月。比较2组患者的汉密顿尔焦虑量表(Hamilton anxiety scale,HAMA)、汉密顿尔抑郁量表(Hamilton depression rating scale,HAMD)、疾病不确定感量表(medical uncertainty inventory scale,MUIS)和欧洲癌症研究与治疗组织(European Organization for Research and Treatment of Cancer,EORTC)患者生活质量核心量表(EORTC quality of life questionnaire-core 30,EORTC-QLQ-C30)评分以及不良反应。结果:干预3个月后,观察组的HAMA、HAMD和MUIS评分分别为14.39±2.70、10.91±2.22和66.36±7.55分,均显著低于对照组(分别为17.76±4.15、15.62±3.34和76.23±10.31分),差异有统计学意义(P<0.05)。观察组的EORTC-QLQ-C30总生活质量评分为81.23±13.26分,高于对照组的73.69±8.45分(P<0.05);症状量表中,观察组的疲倦、恶性和呕吐以及疼痛评分分别为18.75±3.34、24.72±5.18和22.26±3.04分,均低于对照组(分别为29.03±6.07、35.07±8.15和28.31±5.16分)(P<0.05);单项测试中,观察组的失眠评分为18.65±3.37分,低于对照组的22.60±5.24分(P<0.05)。观察组的恶心和呕吐、食欲减退、腹痛腹泻以及血细胞减少发生率均低于对照组(P<0.05)。结论:基于UpToDate的预警模式可以改善乳腺癌术后化疗患者的心理状态,减少不良反应,降低疾病不确定感,提高生活质量。
