TOPLINE:
Despite best efforts, non-clinical practice staff do not appear to benefit from educational interventions aimed at improving the timeliness of shingles diagnosis (ie, within 72-144 hours).
METHODOLOGY:
- Researchers undertook a cluster, randomised study within a trial (SWAT) with a nested qualitative study of English general practices to determine if a practice-based intervention aimed at improving the knowledge of non-clinical staff would improve the timely diagnosis of new-onset shingles.
- The primary outcome was the proportion of patients seen within 72 hours since rash onset.
- Educational intervention included five posters to display in staff areas, desktop backgrounds to be uploaded onto all computers of patient-facing staff (receptionist or administrative staff and clinical staff), and a link to a 1-minute YouTube video.
- Implementation was assessed by requesting an email confirming material receipt, an online survey regarding the number of posters, desktop backgrounds displayed at week 2 and the final month, and YouTube analytics.
- An implementation score on a scale of 0 to 3 was calculated for each practice, with 1 point for engagement with each intervention material.
TAKEAWAY:
- Among the 67 included practices, 34 were randomised to SWAT and 33 to the control group.
- For the primary outcome, the evidence was weak for any distinction between SWAT and control groups in terms of the mean proportion of patients seen within 72 hours of rash onset (SWAT [43.6%] vs control [57.2%]).
- in all, 90.9% (n = 20) of practices distributed the intervention materials to staff; mean percentage of posters displayed was 81.1%; and of practices that screened at least 1 patient, there was a weak positive correlation between implementation score and primary outcome (correlation coefficient, 0.31).
- Qualitative interviews (12 practice staff) demonstrated uncertainty around engagement with materials and failure to see SWAT as an effective intervention.
IN PRACTICE:
“[P]ractice staff did not perceive the intervention as effective, and with staff already facing high workload, it was sometimes not considered worthwhile,” the authors wrote. “Attempting to improve receptionist knowledge to result in improved clinical care for patients…is unlikely to be successful.”
SOURCE:
The study was led by Elizabeth Lovegrove, BSc, BMBS, MRCGP, at the University of Southampton, Southampton, UK, and appeared online in the British Journal of General Practice.
LIMITATIONS:
Limitations included missing data, overestimated practice engagement with the resource, and limited power.
DISCLOSURES:
The study was funded by the National Institute of Health and Care Research. The authors reported no conflicts of interest.
Source link : https://www.medscape.com/s/viewarticle/shingles-diagnosis-repels-techs-best-efforts-2024a100056q?src=rss
Author :
Publish date : 2024-03-22 14:00:00
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