Scoping Review of Off-Label Topical Analgesia in Palliative, Hospice and Cancer Care: Towards Flexibility in Evidence-Based Medicine

IntroductionPatient-centred care is pivotal to clinical practice and medical education. The practice of evidence-based medicine (EBM) and shared decision-making (SDM) are complementary aspects of patient-centred care, but they are frequently taught and reported as independent entities. To effectively perform all steps of EBM, clinicians need to include patients in SDM conversations, however, the uptake of this has been slow and inconsistent. A solution may be the incorporation of SDM into EBM training programmes, but such programmes do not routinely include SDM skills development. This scoping review will survey the literature on the kinds of EBM and SDM educational programmes that exist for recently qualified doctors, programmes that incorporate the teaching of both EBM and SDM skills, as well as identifying research gaps in the literature.Methods and analysisLiterature searches will be conducted in the databases Medline, Embase, Scopus and Cochrane Library. Bibliographies of key articles and their citing references will also be hand-searched and assessed for inclusion. Selected grey literature will be included. Papers must be written in English, or provide English abstracts, and date from 1996 to the present day.Two independent reviewers will screen titles and abstracts, check full texts of selected papers for eligibility and extract the data. Any disagreement will be resolved, and consensus reached, if necessary, with the assistance of a third reviewer. Qualitative and quantitative studies that address educational interventions for either EBM, SDM or both will be included. Data extraction tables will present bibliographic information, populations, interventions, context and outcomes. Data will be summarised using tables and figures and a description of findings.Ethics and disseminationThis review will synthesise information from publicly available publications and does not require ethics approval. The results will be disseminated via conference presentations and publications in medical journals.

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Surveys, Quality Cancer Care, and Evidence-Based Medicine: Embracing Care Delivery Drivers

Annals of Surgical Oncology ◽

10.1245/s10434-008-0154-1 ◽

2008 ◽

Vol 15 (12) ◽

pp. 3333-3334

Author(s):

Lawrence D. Wagman

Keyword(s):

Evidence Based Medicine ◽

Cancer Care ◽

Care Delivery ◽

Evidence Based ◽

Quality Cancer Care ◽

Based Medicine

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Nudging healthcare professionals towards evidence-based medicine: A systematic scoping review

Journal of Behavioral Public Administration ◽

10.30636/jbpa.22.71 ◽

2019 ◽

Vol 2 (2) ◽

Cited By ~ 2

Author(s):

Rosanna Nagtegaal ◽

Lars Tummers ◽

Mirko Noordegraaf ◽

Victor Bekkers

Keyword(s):

Scoping Review ◽

Evidence Based Medicine ◽

Methodological Quality ◽

Healthcare Professionals ◽

Information Overload ◽

Reference Points ◽

Future Research ◽

Evidence Based ◽

Social Reference ◽

Based Medicine

Translating medical evidence into practice is difficult. Key challenges in applying evidence-based medicine are information overload and that evidence needs to be used in context by healthcare professionals. Nudging (i.e. softly steering) healthcare professionals towards utilizing evidence-based medicine may be a feasible possibility. This systematic scoping review is the first overview of nudging healthcare professionals in relation to evidence-based medicine. We have investigated a) the distribution of studies on nudging healthcare professionals, b) the nudges tested and behaviors targeted, c) the methodological quality of studies and d) whether the success of nudges is related to context. In terms of distribution, we found a large but scattered field: 100 articles in over 60 different journals, including various types of nudges targeting different behaviors such as hand hygiene or prescribing drugs. Some nudges – especially reminders to deal with information overload – are often applied, while others - such as providing social reference points – are seldom used. The methodological quality is moderate. Success appears to vary in terms of three contextual characteristics: the task, organizational, and occupational contexts. Based on this review, we propose future research directions, particularly related to methods (preregistered research designs to reduce publication bias), nudges (using less-often applied nudges on less studied outcomes), and context (moving beyond one-size-fits-all approaches).

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