FACTORS INFLUENCING ADHERENCE TO GUIDELINES IN GENERAL PRACTICE

@article{Stewart2003FACTORSIA,
  title={FACTORS INFLUENCING ADHERENCE TO GUIDELINES IN GENERAL PRACTICE},
  author={Roy E. Stewart and Sebastiaan J. Vroegop and G B Kamps and Ger Th van der Werf and Betty Meyboom-de Jong},
  journal={International Journal of Technology Assessment in Health Care},
  year={2003},
  volume={19},
  pages={546 - 554}
}
Objectives: To identify and assess the effects of general practitioner and patient characteristics on global adherence to pharmacotherapeutic guidelines. Methods: In a cross-sectional study in the northern Netherlands, a two-level multilevel model was applied to patients (n=269,067) in 190 practices with a total of 251 general practitioners. The dependent variable was the global adherence to pharmacotherapeutic guidelines as a measure of good prescribing in a general practice setting. Results… 
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The physician's decision to prescribe a recommended statin is conditioned by the socio-economic and demographic characteristics of the patient, and the contextual circumstances of the HCP were also associated with adherence to guidelines.
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Study results suggest that, in general, Spanish doctors trust and use CPGs frequently and should be rigorously developed and made accessible at the point-of-care in user-friendly electronic formats.
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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 and the need for transparency in forming and implementing guidelines should be explored.
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It is suggested that variances in self-reported adherence to venous blood specimen collection guidelines for patient identification and test request handling practices among phlebotomy staff can be largely explained by primary healthcare centre affiliation also when individual and workplace demographic characteristics were taken in consideration.
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It is suggested that creating trust in guidelines could be more important than more efforts to improve guideline format and accessibility and it may also be worth considering whether guidelines should be implemented using different processes in generalist and specialist care.
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A decentralized drug budget seems to promote adherence to guidelines for statin prescription in Scania, Sweden, but the high practice differences at the end of the observation period may reflect inefficient therapeutic traditions, and indicates that rational statin prescriptions could be further improved.
Understanding therapeutic traditions in a multilevel framework - new methodological approaches
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Adherence to guidelines for statin prescription and the early adoption of a new statin seemed to be conditioned by contextual factors particularly at the Health care practice level (HCP) level, as these lipid lowering drugs all have similar indications and efficacy.
Social network analysis in primary care: the impact of interactions on prescribing behaviour.
Perceptions and attitudes of clinicians in Spain toward clinical practice guidelines and grading systems: a protocol for a qualitative study and a national survey
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This study will identify and gain insight into the perceived problems and barriers of Spanish practitioners in relation to guideline knowledge and use, and explore beliefs and attitudes of clinicians towards CPGs and evidence grading systems used to rate the quality of the evidence and the strength of recommendations.
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References

SHOWING 1-10 OF 33 REFERENCES
Adherence to the guidelines of a regional formulary.
TLDR
To assess how strictly the GPs participating in the department's registration network adhere to the guidelines of the regional formulary, and which indications and drugs theGPs used, 1000 consecutive prescriptions from each of the 17 participating GPs were analyzed.
Pharmacotherapeutic circles. Results of an 18-month peer-review prescribing-improvement programme for general practitioners.
TLDR
PTCs appear to be an effective method to optimise the quality of drug prescribing and reduce drug costs.
Attributes of clinical guidelines that influence use of guidelines in general practice: observational study
TLDR
People and organisations setting evidence based clinical practice guidelines should take into account some of the other important attributes of effective recommendations for clinical practice, including evidence based, controversial, concrete.
Randomised controlled trial of effect of feedback on general practitioners' prescribing in Australia
TLDR
The form of feedback evaluated here—mailed, unsolicited, centralised, government sponsored, and based on aggregate data—had no impact on the prescribing levels of general practitioners.
Influences of practice characteristics on prescribing in fundholding and non-fundholding general practices: an observational study
TLDR
In neither year did fundholding make a major contribution to the variation in prescribing behaviour among practices, which was better explained by deprivation, training status, and partnership status, but it did seem largely responsible for differences in the rise of total prescribing costs between fundholders and non-fundholders.
General practitioners' views on the appropriateness of their long-term prescribing
TLDR
Application of validated prescribing indicators identified cases where GPs agreed that their prescribing for individual patients was inappropriate, including three clear factors that may go some way towards explaining apparently inappropriate prescribing and be used to form strategies to improve the quality of long-term prescribing in general practice.
Variations in general practice prescribing: a multilevel model approach to determine the impact of practice characteristics, including fundholding and training status
TLDR
There are marked downward shifts in both the number of items prescribed and overall monthly expenditure occurring with every new wave of fundholding, which raises doubts about the efficacy of the transition to fundholding and the impact of such large changes upon patient care.
Elderly patients in general practice: diagnoses, drugs and inappropriate prescriptions. A report from the Møre & Romsdal Prescription Study.
TLDR
Drug prescribing in general practice for elderly patients is described, using patients' age and sex, encounters, indications for prescribing and the occurrence of some predefined inappropriate drug prescriptions to identify prescribing problems.
Can drug treatment be improved by feedback on prescribing profiles combined with therapeutic recommendations? A prospective, controlled trial in general practice.
Rational prescribing and interpractitioner variation. A multilevel approach.
  • P. Davis, B. Gribben
  • Medicine
    International journal of technology assessment in health care
  • 1995
TLDR
Data from a survey of general practice in New Zealand confirm the existence of extensive variability in prescribing and raises questions about the role of clinical uncertainty and professional autonomy in the promotion of rational therapeutics in medical practice.
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