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.

Autor:	Suttels V; Infectious Diseases, CHUV, Lausanne, Switzerland veronique.suttels@outlook.com., Guedes Da Costa S; Research Center for Psychology of Health, Aging and Sport Examination (PHASE), University of Lausanne, Lausanne, Switzerland., Garcia E; Emergency Department, CHUV, Lausanne, Switzerland., Brahier T; Infectious Diseases, CHUV, Lausanne, Switzerland., Hartley MA; Digital Global Health Department, University of Lausanne, Lausanne, Switzerland.; Intelligent Global Health Research Group, Swiss Institute of Technology (EPFL), Lausanne, Switzerland., Agodokpessi G; National Hospital Center of Pneumology, University of Abomey-Calavi, Cotonou, Benin., Wachinou P; National Hospital Center of Pneumology, University of Abomey-Calavi, Cotonou, Benin., Fasseur F; Research Center for Psychology of Health, Aging and Sport Examination (PHASE), University of Lausanne, Lausanne, Switzerland., Boillat-Blanco N; Infectious Diseases, CHUV, Lausanne, Switzerland.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2023 Jun 26; Vol. 13 (6), pp. e070765. Date of Electronic Publication: 2023 Jun 26.
DOI:	10.1136/bmjopen-2022-070765
Abstrakt:	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. Competing Interests: Competing interests: None declared. (© 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.)
Databáze:	MEDLINE
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