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: | Gildas Agodokpessi, Elena Garcia, Noémie Boillat-Blanco, Thomas Brahier, Mary-Anne Hartley, Fabienne Fasseur, Veronique Suttels, Sofia Guedes Da Costa, Prudence Wachinou |
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| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | BMJ Open, Vol 13, Iss 6 (2023) |
| Druh dokumentu: | article |
| ISSN: | 2022-0707 2044-6055 |
| DOI: | 10.1136/bmjopen-2022-070765 |
| Popis: | 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. |
| Databáze: | Directory of Open Access Journals |
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