The implementation of the consensus on the management of Helicobacter pylori and barriers to consensus |
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| Authors: | Hsiu‐Chi Cheng Jyh‐Ming Liou Jiing‐Chyuan Luo Cheng‐Tang Chiu Ming‐Shiang Wu Yi‐Chia Lee Chun‐Ying Wu Deng‐Chyang Wu Ping‐I Hsu Chun‐Chao Chang Wei‐Lun Chang Jaw‐Town Lin Bor‐Shyang Sheu |
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| Institution: | 1. Institute of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan;2. Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan;3. Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan;4. Division of Gastroenterology and Hepatology, Taipei Veterans General Hospital, Taipei, Taiwan;5. Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan;6. Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan;7. Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan;8. Division of Translational Research, Taipei Veterans General Hospital, Taipei, Taiwan;9. Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;10. Center for Infectious Disease and Cancer Research, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;11. Center for Stem Cell Research, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;12. Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan;13. Department of Internal Medicine, Kaohsiung Municipal Ta‐Tung Hospital, Kaohsiung, Taiwan;14. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan;15. School of Medicine, National Yang‐Ming University, Taipei, Taiwan;16. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan;17. Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;18. Big Data Research Center, School of Medicine, Fu Jen Catholic University, New Taipei, Taiwan;19. Division of Gastroenterology, Fu Jen Catholic University Hospital, New Taipei, Taiwan;20. Department of Internal Medicine, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan |
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| Abstract: | Background A consensus on the management of Helicobacter pylori has been developed. We aimed to assess whether dissemination through continuing medical education (CME) could enhance the adoption of this consensus among clinicians and to explore potential barriers to acceptance. Materials and methods Four CME courses were held to disseminate the consensus. Adoption surveys were performed to evaluate participants’ behavior in the past and their commitment to adopt the consensus in future clinical practice after CME. The gaps and barriers to adoption were also surveyed. Results A total of 240 physicians had attended the CME courses and received surveys with the 22 statements/substatements of the consensus. Before CME, adoption was good in six, fair in ten, and poor in six. After CME, 21 statements had either an initial >90% adoption or improvement to good or fair (P < 0.001), but one still had poor even though it showed improvement (P = 0.02). Although commitment was good or fair after CME, there was a >20% gap between “commitment” and “no barrier” to adoption for 11 statements, ten of which had a main barrier of financial incentives. Among the statements with fair or poor commitment after CME, less commitment to adoption and more barriers related to financial incentives were pronounced in clinicians serving in regional/district hospitals or clinics compared to those serving in medical centers. Conclusions Continuing medical education may improve the adoption of the H. pylori consensus. The financial incentives were shown to be a main barrier to adoption of the consensus and should be improved. |
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| Keywords: | barrier consensus guideline
Helicobacter pylori
implementation |
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