ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 111
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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Implementing clinical ultrasonography in primary care:
Early implementation process assessment
Dr Oana Bulilete1,5, Maria Cruellas Garau2, Natalia Shengeliya3, Celia López Cleries3, Antonia Roca
Casas4,5, Magdalena Esteva Canto1,5
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Primary Care Research Unit, Mallorca, Balearic Public Health Service, 2Palliative Care Unit, Joan
March Hospital, Mallorca, 3Santa Ponça Primary Healthcare Center, Mallorca, 4Trencadors Primary
Healthcare Center, Mallorca, 5Health Research Institute of the Balearic Islands (IdISBa)
Background
Clinical ultrasound at the point-of-care (POCUS) has been linked to better diagnostic pathways, more
appropriate treatment for common diseases in primary care (PC), fewer referrals to other levels of care
and patient health outcomes. Its implementation in PC may be hampered by several factors, including
lack of training, time pressure, resistance from other care settings or potential secondary effects from
incidental findings and overdiagnosis.
Objective
The aims were to conduct an early evaluation of the POCUS implementation process in PC in terms of
acceptability, adoption, adequacy and perceived effectiveness; and to compare the characteristics of
high (HI) versus slow (SI) implementers.
Methods
Descriptive study, general practitioners previously trained in using POCUS.
Information
Online questionnaire
Variables
Sociodemographic, working characteristics; reason, barriers and enablers of use; implementation
outcomes (RE-AIM methodology): acceptability, adoption, adequacy and perceived effectiveness; HI:
performing four or more POCUS/month.
Results
Response rate 61.3% (103/168); mean age 50 ± 9.3 years; female 62.1%; urban practice 67.0%.
Barriers for POCUS use: lack of time 86.4%; lack of training 57.3%; lack of confidence 63.1%.
Adoption: HI 21/100 (21.0%); mean time to perform a POCUS 18.4 ± 7.0 minutes HI vs 20.7 ± 7.1 SI;
out-of-hour services HI 52.4% vs 25.3%, P0.03; POCUS use: for acute disorders HI 100% vs 81.9%
SI, P0.03; musculoskeletal HI 81.0% vs 48.1%, P0.01. Adequacy: ease to use HI 100% vs 81.9% SI,
P0.03; suitable for PC 95.2% HI vs 92.4% SI, P1.00. Acceptability: high satisfaction degree HI 100%
vs 78.2%, P0.02; high confidence in the results HI 22.8 vs 52.4%, P0.01. Perceived effectiveness:
improved diagnosis and care HI 81.0% vs 89.9% SI, P0.27; improved referral circuit 61.9% vs 50.6%
SI, P0.46.
Conclusions
The majority of family physicians reported high levels of satisfaction using POCUS, which was deemed
an appropriate technique for PC. During the implementation phase, stakeholders must take into
account challenges such as a lack of training or time.
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