Factors Influencing Adherence to Guidelines in General Practice

Abstract

Patient characteristics have a greater influence on prescribing behavior than general practitioner characteristics.

GPs' implicit prioritization through clinical choices – evidence from three national health services

“…The initial identification of relevant attributes was based predominantly on findings from an earlier survey of Norwegian doctors' adherence to guidelines (Carlsen & Aakvik, 2006;Carlsen & Norheim, 2008), existing international research on both prioritization and guidelines (Carlsen & Norheim, 2005;Eccles & Grimshaw, 2004;Farquhar et al, 2002;Stewart et al, 2003;Strech et al, 2008), as well as theoretical expertise and practical experience (with DCEs in general and with conducting DCEs in different local contexts) in the international research team. The choice models applied in the analysis rely on the assumption that respondents are able to make trade-offs between attributes and their levels in order to maximise utility.…”

Thou shalt versus thou shalt not: a meta-synthesis of GPs' attitudes to clinical practice guidelines

“…3,[5][6][7]11 The present findings offer reasons as to why some GPs do not follow guidelines; these mainly relate to individual patient needs. The findings fit well with studies of why evidence is not implemented in general practice, [37][38][39] and echo the critique repeatedly made of evidence-based medicine compared with experience-based knowledge.…”

“…[3][4][5][6][7][8][9][10] A recent review of quantitative studies of GPs' attitudes to implementation provides an overview of the frequency and distribution of attitudinal barriers to guidelines, but does not offer an understanding of what underpins these. 11 While there have been several qualitative studies exploring GPs' attitudes towards guidelines, there has been no attempt to review and synthesise their findings systematically.…”

Quality of Care Measures for the Treatment of Bipolar Disorder

“…When indicators are used in this manner, however, it is essential to recognize that deviations from guideline recommended care often may be appropriate. The clinical complexities of individual patients, such as somatic or psychiatric comorbidities and past adverse reaction to medications may significantly alter treatment choices available to individual patients and thus explain lack of adherence to guideline recommendations (33,34). Also, patient preferences may play an important role in clinical decisions regarding the use of particular psychopharmacologic agents, psychotherapies, or other treatment modalities.…”