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Barriers and facilitators to implementation of point-of-care lung ultrasonography in a tertiary centre in Benin: a qualitative study among general physicians and pneumologists

OBJECTIVES: Owing to its ease-of-use and excellent diagnostic performance for the assessment of respiratory symptoms, point-of-care lung ultrasound (POC-LUS) has emerged as an attractive skill in resource-low settings, where limited access to specialist care and inconsistent radiology services erode...

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Autores principales: Suttels, Veronique, Guedes Da Costa, Sofia, Garcia, Elena, Brahier, Thomas, Hartley, Mary-Anne, Agodokpessi, Gildas, Wachinou, Prudence, Fasseur, Fabienne, Boillat-Blanco, Noémie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10357755/
https://www.ncbi.nlm.nih.gov/pubmed/37369423
http://dx.doi.org/10.1136/bmjopen-2022-070765
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author Suttels, Veronique
Guedes Da Costa, Sofia
Garcia, Elena
Brahier, Thomas
Hartley, Mary-Anne
Agodokpessi, Gildas
Wachinou, Prudence
Fasseur, Fabienne
Boillat-Blanco, Noémie
author_facet Suttels, Veronique
Guedes Da Costa, Sofia
Garcia, Elena
Brahier, Thomas
Hartley, Mary-Anne
Agodokpessi, Gildas
Wachinou, Prudence
Fasseur, Fabienne
Boillat-Blanco, Noémie
author_sort Suttels, Veronique
collection PubMed
description OBJECTIVES: Owing to its ease-of-use and excellent diagnostic performance for the assessment of respiratory symptoms, point-of-care lung ultrasound (POC-LUS) has emerged as an attractive skill in resource-low settings, where limited access to specialist care and inconsistent radiology services erode health equity. To narrow down the research to practice gap, this study aims to gain in-depth insights in the perceptions on POC-LUS and computer-assisted POC-LUS for the diagnosis of lower respiratory tract infections (LRTIs) in a low-income and middle-income country (LMIC) of sub-Saharan Africa. DESIGN AND SETTING: Qualitative study using face-to-face semi-structured interviews with three pneumologists and five general physicians in a tertiary centre for pneumology and tuberculosis in Benin, West Africa. The center hosts a prospective cohort study on the diagnostic performance of POC-LUS for LRTI. In this context, all participants started a POC-LUS training programme 6 months before the current study. Transcripts were coded by the interviewer, checked for intercoder reliability by an independent psychologist, compared and thematically summarised according to grounded theory methods. RESULTS: Various barriers− and facilitators+ to POC-LUS implementation were identified related to four principal categories: (1) hospital setting (eg, lack of resources for device renewal or maintenance−, need for POC tests+), (2) physician’s perceptions (eg, lack of opportunity to practice−, willingness to appropriate the technique+), (3) tool characteristics (eg, unclear lifespan−, expedited diagnosis+) and (4) patient’s experience (no analogous image to keep−, reduction in costs+). Furthermore, all interviewees had positive attitudes towards computer-assisted POC-LUS. CONCLUSIONS: There is a clear need for POC affordable lung imaging techniques in LMIC and physicians are willing to implement POC-LUS to optimise the diagnostic approach of LRTI with an affordable tool. Successful integration of POC-LUS into clinical routine will require adequate responses to local challenges related to the lack of available maintenance resources and limited opportunity to supervised practice for physicians.
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spelling pubmed-103577552023-07-21 Barriers and facilitators to implementation of point-of-care lung ultrasonography in a tertiary centre in Benin: a qualitative study among general physicians and pneumologists Suttels, Veronique Guedes Da Costa, Sofia Garcia, Elena Brahier, Thomas Hartley, Mary-Anne Agodokpessi, Gildas Wachinou, Prudence Fasseur, Fabienne Boillat-Blanco, Noémie BMJ Open Qualitative Research OBJECTIVES: Owing to its ease-of-use and excellent diagnostic performance for the assessment of respiratory symptoms, point-of-care lung ultrasound (POC-LUS) has emerged as an attractive skill in resource-low settings, where limited access to specialist care and inconsistent radiology services erode health equity. To narrow down the research to practice gap, this study aims to gain in-depth insights in the perceptions on POC-LUS and computer-assisted POC-LUS for the diagnosis of lower respiratory tract infections (LRTIs) in a low-income and middle-income country (LMIC) of sub-Saharan Africa. DESIGN AND SETTING: Qualitative study using face-to-face semi-structured interviews with three pneumologists and five general physicians in a tertiary centre for pneumology and tuberculosis in Benin, West Africa. The center hosts a prospective cohort study on the diagnostic performance of POC-LUS for LRTI. In this context, all participants started a POC-LUS training programme 6 months before the current study. Transcripts were coded by the interviewer, checked for intercoder reliability by an independent psychologist, compared and thematically summarised according to grounded theory methods. RESULTS: Various barriers− and facilitators+ to POC-LUS implementation were identified related to four principal categories: (1) hospital setting (eg, lack of resources for device renewal or maintenance−, need for POC tests+), (2) physician’s perceptions (eg, lack of opportunity to practice−, willingness to appropriate the technique+), (3) tool characteristics (eg, unclear lifespan−, expedited diagnosis+) and (4) patient’s experience (no analogous image to keep−, reduction in costs+). Furthermore, all interviewees had positive attitudes towards computer-assisted POC-LUS. CONCLUSIONS: There is a clear need for POC affordable lung imaging techniques in LMIC and physicians are willing to implement POC-LUS to optimise the diagnostic approach of LRTI with an affordable tool. Successful integration of POC-LUS into clinical routine will require adequate responses to local challenges related to the lack of available maintenance resources and limited opportunity to supervised practice for physicians. BMJ Publishing Group 2023-06-26 /pmc/articles/PMC10357755/ /pubmed/37369423 http://dx.doi.org/10.1136/bmjopen-2022-070765 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Qualitative Research
Suttels, Veronique
Guedes Da Costa, Sofia
Garcia, Elena
Brahier, Thomas
Hartley, Mary-Anne
Agodokpessi, Gildas
Wachinou, Prudence
Fasseur, Fabienne
Boillat-Blanco, Noémie
Barriers and facilitators to implementation of point-of-care lung ultrasonography in a tertiary centre in Benin: a qualitative study among general physicians and pneumologists
title Barriers and facilitators to implementation of point-of-care lung ultrasonography in a tertiary centre in Benin: a qualitative study among general physicians and pneumologists
title_full Barriers and facilitators to implementation of point-of-care lung ultrasonography in a tertiary centre in Benin: a qualitative study among general physicians and pneumologists
title_fullStr Barriers and facilitators to implementation of point-of-care lung ultrasonography in a tertiary centre in Benin: a qualitative study among general physicians and pneumologists
title_full_unstemmed Barriers and facilitators to implementation of point-of-care lung ultrasonography in a tertiary centre in Benin: a qualitative study among general physicians and pneumologists
title_short Barriers and facilitators to implementation of point-of-care lung ultrasonography in a tertiary centre in Benin: a qualitative study among general physicians and pneumologists
title_sort barriers and facilitators to implementation of point-of-care lung ultrasonography in a tertiary centre in benin: a qualitative study among general physicians and pneumologists
topic Qualitative Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10357755/
https://www.ncbi.nlm.nih.gov/pubmed/37369423
http://dx.doi.org/10.1136/bmjopen-2022-070765
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