ABSTRACT
Aims: New cough guidelines recommend a wait, watch and review attitude without any prescription of medication. However, practitioner adhesion is low. We aimed to search what alternative physician could proposed to drug prescription and what attitude could be effective. Study Design: Review of the litterature. Methodology: The review was performed by two reviewers covering the period from 2008, the date we finished the literature search for our previous guidelines, to March 2015 for guideline, systematic reviews and RCTs. The inclusion criteria were interventions without pharmacological treatment compared with no treatment in coughing children. The target population was the paediatric population between 0 and 18 years old, suffering from cough and not known to be suffering from a specific lung disease. Results: We found three systematic reviews and two primary articles. Interventions used were honey, placebo, GP’s communication skill, and written material given to parents. Outcomes were perception of cough by the parents as assessed by Likert scales, consultation rate and parental literacy. Placebo or honey seemed to be more efficient as regards parents’ perception of their child’s cough. Providing parents with informative, illustrated booklets had an effect on the parents’ knowledge and intention to consult about such symptoms. Conclusion: Our findings support the recommendation of giving information to parents. Placebo seemed to be more efficient than nothing. Its proper use should be specified. There is a need for other studies on which approach works in which circumstances, and when placebo or sugar syrups could be useful.
ABSTRACT
This article aims to analyse the editorial activities of Minerva, a Belgian evidence-based medicine (EBM) journal, according to the guidelines of quaternary prevention. From the editorial production of Minerva, a narrative analysis of its writing activities was carried out in relation to clinical questioning, research, critics and interpretation of relevant clinical information to professional practice. The limits of EBM are clearly detailed, as well as the tools and lines of reflection issued by the editorial team in order to promote the implementation of EBM in clinical practice. In this way, it is intended to prevent unnecessary medical interventions by strengthening the quaternary prevention as a key competence of healthcare staff throughout their professional life to the service of patients, which may be reinforced by the work of the editorial team of an EBM journal.
O presente artigo tem como objetivo analisar as atividades de redação da revista Minerva, periódico belga de medicina baseada em evidência (MBE), de acordo com as diretrizes da prevenção quaternária. A partir da produção editorial da revista Minerva foi realizada uma análise narrativa de suas atividades de redação em relação ao questionamento clínico, à pesquisa, à crítica e à interpretação de informações clínicas relevantes à prática profissional. São detalhados os limites da MBE e as ferramentas e linhas de reflexão emitidas pela equipe de redação da revista a fim de favorecer a implementação da MBE na prática clínica. Dessa forma, se pretende prevenir o intervencionismo médico desnecessário, ao se fortalecer a prevenção quaternária como uma competência fundamental dos trabalhadores da saúde ao longo de sua vida profissional a serviço dos pacientes, o que pode ser reforçado pelo trabalho da equipe editorial de uma revista de MBE.
Este artículo tiene como objetivo analizar las actividades editoriales de la revista Minerva, periódico belga de medicina basada en evidencia (MBE), de acuerdo con las directrices de la prevención cuaternaria. A partir de la producción editorial de la revista Minerva, fue realizada un análisis narrativo de sus actividades de redacción en relación con el cuestionamiento clínico, la investigación, la crítica y la interpretación de la información clínica relevante para la práctica profesional. Se detalla los límites de la MBE y las herramientas y líneas de reflexión emitidas por el equipo de redacción de la revista, con el fin de promover la aplicación de la MBE en la práctica clínica. Por tanto, si desea evitar la intervención médica innecesaria, al fortalecer la prevención cuaternaria como competencia clave de los trabajadores de salud durante toda su vida profesional al servicio de los pacientes, lo que puede ser reforzado por el trabajo de la equipo de redacción de una revista de MBE.