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Swedish general practitioners attitudes towards treatment guidelines a qualitative study

Milos, Veronica LU ; Westerlund, Tommy; Midlöv, Patrik LU and Strandberg, Eva-Lena LU (2014) In BMC Family Practice 15.
Abstract
Background: Drug therapy in primary care is a challenge for general practitioners (GPs) and the prescribing decision is influenced by several factors. GPs obtain drug information in different ways, from evidence-based sources, their own or others? experiences, or interactions with opinion makers, patients or colleagues. The need for objective drug information sources instead of drug industry-provided information has led to the establishment of local drug and therapeutic committees. They annually produce and implement local treatment guidelines in order to promote rational drug use. This study describes Swedish GPs? attitudes towards locally developed evidence-based treatment guidelines. Methods: Three focus group interviews were performed... (More)
Background: Drug therapy in primary care is a challenge for general practitioners (GPs) and the prescribing decision is influenced by several factors. GPs obtain drug information in different ways, from evidence-based sources, their own or others? experiences, or interactions with opinion makers, patients or colleagues. The need for objective drug information sources instead of drug industry-provided information has led to the establishment of local drug and therapeutic committees. They annually produce and implement local treatment guidelines in order to promote rational drug use. This study describes Swedish GPs? attitudes towards locally developed evidence-based treatment guidelines. Methods: Three focus group interviews were performed with a total of 17 GPs working at both public and private primary health care centres in Sk?ne in southern Sweden. Transcripts were analysed by conventional content analysis. Codes, categories and themes were derived from data during the analysis. Results: We found two main themes: GP-related influencing factors and External influencing factors. The first theme emerged when we put together four main categories: Expectations and perceptions about existing local guidelines, Knowledge about evidence-based prescribing, Trust in development of guidelines, and Beliefs about adherence to guidelines. The second theme included the categories Patient-related aspects, Drug industry-related aspects, and Health economic aspects. The time-saving aspect, trust in evidence-based market-neutral guidelines and patient safety were described as key motivating factors for adherence. Patient safety was reported to be more important than adherence to guidelines or maintaining a good patient-doctor relationship. Cost containment was perceived both as a motivating factor and a barrier for adherence to guidelines. GPs expressed concerns about difficulties with adherence to guidelines when managing patients with drugs from other prescribers. GPs experienced a lack of time to self-inform and difficulties managing direct-to-consumer drug industry information. Conclusions: Patient safety, trust in development of evidence-based recommendations, the patient-doctor encounter and cost containment were found to be key factors in GPs? prescribing. Future studies should explore the need for transparency in forming and implementing guidelines, which might potentially increase adherence to evidence-based treatment guidelines in primary care. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Qualitative research, Focus groups, Guidelines, Attitudes, Primary care, GPs, Adherence, Drug therapy
in
BMC Family Practice
volume
15
publisher
BioMed Central
external identifiers
  • wos:000348109600001
  • scopus:84923920225
ISSN
1471-2296
DOI
10.1186/s12875-014-0199-0
language
English
LU publication?
yes
id
880c4aa6-69b3-4c77-93b8-1fd7d1ee566c (old id 5070066)
date added to LUP
2015-03-02 07:03:57
date last changed
2017-10-08 04:07:20
@article{880c4aa6-69b3-4c77-93b8-1fd7d1ee566c,
  abstract     = {Background: Drug therapy in primary care is a challenge for general practitioners (GPs) and the prescribing decision is influenced by several factors. GPs obtain drug information in different ways, from evidence-based sources, their own or others? experiences, or interactions with opinion makers, patients or colleagues. The need for objective drug information sources instead of drug industry-provided information has led to the establishment of local drug and therapeutic committees. They annually produce and implement local treatment guidelines in order to promote rational drug use. This study describes Swedish GPs? attitudes towards locally developed evidence-based treatment guidelines. Methods: Three focus group interviews were performed with a total of 17 GPs working at both public and private primary health care centres in Sk?ne in southern Sweden. Transcripts were analysed by conventional content analysis. Codes, categories and themes were derived from data during the analysis. Results: We found two main themes: GP-related influencing factors and External influencing factors. The first theme emerged when we put together four main categories: Expectations and perceptions about existing local guidelines, Knowledge about evidence-based prescribing, Trust in development of guidelines, and Beliefs about adherence to guidelines. The second theme included the categories Patient-related aspects, Drug industry-related aspects, and Health economic aspects. The time-saving aspect, trust in evidence-based market-neutral guidelines and patient safety were described as key motivating factors for adherence. Patient safety was reported to be more important than adherence to guidelines or maintaining a good patient-doctor relationship. Cost containment was perceived both as a motivating factor and a barrier for adherence to guidelines. GPs expressed concerns about difficulties with adherence to guidelines when managing patients with drugs from other prescribers. GPs experienced a lack of time to self-inform and difficulties managing direct-to-consumer drug industry information. Conclusions: Patient safety, trust in development of evidence-based recommendations, the patient-doctor encounter and cost containment were found to be key factors in GPs? prescribing. Future studies should explore the need for transparency in forming and implementing guidelines, which might potentially increase adherence to evidence-based treatment guidelines in primary care.},
  articleno    = {199},
  author       = {Milos, Veronica and Westerlund, Tommy and Midlöv, Patrik and Strandberg, Eva-Lena},
  issn         = {1471-2296},
  keyword      = {Qualitative research,Focus groups,Guidelines,Attitudes,Primary care,GPs,Adherence,Drug therapy},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {BMC Family Practice},
  title        = {Swedish general practitioners attitudes towards treatment guidelines a qualitative study},
  url          = {http://dx.doi.org/10.1186/s12875-014-0199-0},
  volume       = {15},
  year         = {2014},
}