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Management of patients with sore throats in relation to guidelines: An interview study in Sweden.

Hedin, Katarina LU ; Strandberg, Eva-Lena LU ; Gröndal, Hedvig; Brorsson, Annika LU ; Thulesius, Hans LU and André, Malin (2014) In Scandinavian Journal of Primary Health Care 32(4). p.193-199
Abstract
Objective. To explore how a group of Swedish general practitioners (GPs) manage patients with a sore throat in relation to current guidelines as expressed in interviews. Design. Qualitative content analysis was used to analyse semi-structured interviews. Setting. Swedish primary care. Subjects. A strategic sample of 25 GPs. Main outcome measures. Perceived management of sore throat patients. Results. It was found that nine of the interviewed GPs were adherent to current guidelines for sore throat and 16 were non-adherent. The two groups differed in terms of guideline knowledge, which was shared within the team for adherent GPs while idiosyncratic knowledge dominated for the non-adherent GPs. Adherent GPs had no or low concerns for... (More)
Objective. To explore how a group of Swedish general practitioners (GPs) manage patients with a sore throat in relation to current guidelines as expressed in interviews. Design. Qualitative content analysis was used to analyse semi-structured interviews. Setting. Swedish primary care. Subjects. A strategic sample of 25 GPs. Main outcome measures. Perceived management of sore throat patients. Results. It was found that nine of the interviewed GPs were adherent to current guidelines for sore throat and 16 were non-adherent. The two groups differed in terms of guideline knowledge, which was shared within the team for adherent GPs while idiosyncratic knowledge dominated for the non-adherent GPs. Adherent GPs had no or low concerns for bacterial infections and differential diagnosis whilst non-adherent GPs believed that in patients with a sore throat any bacterial infection should be identified and treated with antibiotics. Patient history and examination was mainly targeted by adherent GPs whilst for non-adherent GPs it was often redundant. Non-adherent GPs reported problems getting patients to abstain from antibiotics, whilst no such problems were reported in adherent GPs. Conclusion. This interview study of sore throat management in a strategically sampled group of Swedish GPs showed that while two-thirds were non-adherent and had a liberal attitude to antibiotics one-third were guideline adherent with a restricted view on antibiotics. Non-adherent GPs revealed significant knowledge gaps. Adherent GPs had discussed guidelines within the primary care team while non-adherent GPs had not. Guideline implementation thus seemed to be promoted by knowledge shared in team discussions. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scandinavian Journal of Primary Health Care
volume
32
issue
4
pages
193 - 199
publisher
Taylor & Francis
external identifiers
  • pmid:25363143
  • wos:000346108700008
  • scopus:84917742711
ISSN
0281-3432
DOI
10.3109/02813432.2014.972046
language
English
LU publication?
yes
id
9a7cfa5f-56ef-49aa-b357-34b7682d09e7 (old id 4820404)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/25363143?dopt=Abstract
date added to LUP
2014-12-01 18:31:23
date last changed
2017-03-26 03:19:40
@article{9a7cfa5f-56ef-49aa-b357-34b7682d09e7,
  abstract     = {Objective. To explore how a group of Swedish general practitioners (GPs) manage patients with a sore throat in relation to current guidelines as expressed in interviews. Design. Qualitative content analysis was used to analyse semi-structured interviews. Setting. Swedish primary care. Subjects. A strategic sample of 25 GPs. Main outcome measures. Perceived management of sore throat patients. Results. It was found that nine of the interviewed GPs were adherent to current guidelines for sore throat and 16 were non-adherent. The two groups differed in terms of guideline knowledge, which was shared within the team for adherent GPs while idiosyncratic knowledge dominated for the non-adherent GPs. Adherent GPs had no or low concerns for bacterial infections and differential diagnosis whilst non-adherent GPs believed that in patients with a sore throat any bacterial infection should be identified and treated with antibiotics. Patient history and examination was mainly targeted by adherent GPs whilst for non-adherent GPs it was often redundant. Non-adherent GPs reported problems getting patients to abstain from antibiotics, whilst no such problems were reported in adherent GPs. Conclusion. This interview study of sore throat management in a strategically sampled group of Swedish GPs showed that while two-thirds were non-adherent and had a liberal attitude to antibiotics one-third were guideline adherent with a restricted view on antibiotics. Non-adherent GPs revealed significant knowledge gaps. Adherent GPs had discussed guidelines within the primary care team while non-adherent GPs had not. Guideline implementation thus seemed to be promoted by knowledge shared in team discussions.},
  author       = {Hedin, Katarina and Strandberg, Eva-Lena and Gröndal, Hedvig and Brorsson, Annika and Thulesius, Hans and André, Malin},
  issn         = {0281-3432},
  language     = {eng},
  number       = {4},
  pages        = {193--199},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Primary Health Care},
  title        = {Management of patients with sore throats in relation to guidelines: An interview study in Sweden.},
  url          = {http://dx.doi.org/10.3109/02813432.2014.972046},
  volume       = {32},
  year         = {2014},
}