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Developing clinical decision tools to implement chronic disease prevention and screening in primary care: the BETTER 2 program (building on existing tools to improve chronic disease prevention and screening in primary care)

機(jī)譯：開發(fā)臨床決策工具以實(shí)施初級(jí)保健中的慢性病預(yù)防和篩查：BETTER 2計(jì)劃（在現(xiàn)有工具的基礎(chǔ)上改進(jìn)初級(jí)保健中的慢性病預(yù)防和篩查）

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BackgroundThe Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Family Practice (BETTER) trial demonstrated the effectiveness of an approach to chronic disease prevention and screening (CDPS) through a new skilled role of a ‘prevention practitioner’(PP). The PP has appointments with patients 40–65 years of age that focus on primary prevention activities and screening of cancer (breast, colorectal, cervical), diabetes and cardiovascular disease and associated lifestyle factors. There are numerous and occasionally conflicting evidence-based guidelines for CDPS, and the majority of these guidelines are focused on specific diseases or conditions; however, primary care providers often attend to patients with multiple conditions. To ensure that high-level evidence guidelines were used, existing clinical practice guidelines and tools were reviewed and integrated into blended BETTER tool kits. Building on the results of the BETTER trial, the BETTER tools were updated for implementation of the BETTER 2 program into participating urban, rural and remote communities across Canada.
機(jī)譯：背景：在“現(xiàn)有的改善家庭實(shí)踐中的慢性病預(yù)防和篩查工具”（BETTER）試驗(yàn)中，通過“預(yù)防從業(yè)者”（PP）的新技能角色，證明了慢性病預(yù)防和篩查（CDPS）方法的有效性。 PP任命了40-65歲的患者，這些患者側(cè)重于一級(jí)預(yù)防活動(dòng)以及癌癥（乳腺癌，結(jié)腸直腸癌，宮頸癌），糖尿病和心血管疾病以及相關(guān)生活方式因素的篩查。 CDPS有許多基于證據(jù)的指南，有時(shí)甚至相互矛盾，并且這些指南中的大多數(shù)都針對(duì)特定的疾病或狀況。然而，初級(jí)保健提供者經(jīng)常照顧患有多種疾病的患者。為確保使用高級(jí)證據(jù)指南，對(duì)現(xiàn)有的臨床實(shí)踐指南和工具進(jìn)行了審查，并將其整合到混合的BETTER工具包中。在BETTER試驗(yàn)結(jié)果的基礎(chǔ)上，更新了BETTER工具，以便在加拿大各地的城市，農(nóng)村和偏遠(yuǎn)社區(qū)中實(shí)施BETTER 2計(jì)劃。

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