Literature DB >> 10497607

Practice guidelines for clinical prevention: do patients, physicians and experts share common ground?

M D Beaulieu1, E Hudon, D Roberge, R Pineault, D Forté, J Légaré.   

Abstract

BACKGROUND: Clinical practice guidelines, such as those of the Canadian Task Force on Preventive Health Care, although based on sound evidence, may conflict with the perceived needs and expectations of patients and physicians. This may jeopardize the implementation of such guidelines. This study was undertaken to explore patients' and family physicians' acceptance of the task force's recommendations and the values and criteria upon which the opinions of these 2 groups are based.
METHODS: Focus groups were used to collect study data. In total, 35 physicians (in 7 groups) and 75 patient representatives (in 9 groups) participated in the focus groups. An inductive approach was used to develop coding grids and to generate themes from the transcripts of the interviews.
RESULTS: Physicians expressed resistance to discontinuing the annual check-up, which they viewed as an organizational strategy to counteract the many barriers to preventive care that they encounter. They reported difficulties in explaining to their patients the recommendations of the Canadian Task Force on Preventive Health Care, which they found complex and inconsistent with popular wisdom. Both patients and physicians attributed high value to the detection of insidious diseases, even in the absence of proof of the effectiveness of such activity.
INTERPRETATION: The patients and family physicians who participated in this study shared many opinions on the value of preventive activities that depart from the values used by "prevention experts" such as the Canadian Task Force on Preventive Health Care in establishing their recommendations. A better understanding of the values of patients and physicians would help guideline developers to create better targeted communication strategies to take these discrepancies into account.

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Mesh:

Year:  1999        PMID: 10497607      PMCID: PMC1230580     

Source DB:  PubMed          Journal:  CMAJ        ISSN: 0820-3946            Impact factor:   8.262


  11 in total

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Authors:  B S Mittman; X Tonesk; P D Jacobson
Journal:  QRB Qual Rev Bull       Date:  1992-12

2.  Why is preventive medicine exempted from ethical constraints?

Authors:  P Skrabanek
Journal:  J Med Ethics       Date:  1990-12       Impact factor: 2.903

3.  Do health service organizations and community health centres have higher disease prevention and health promotion levels than fee-for-service practices?

Authors:  J Abelson; J Lomas
Journal:  CMAJ       Date:  1990-03-15       Impact factor: 8.262

4.  Patients' desires and expectations for medical care in primary care clinics.

Authors:  J K Zemencuk; J W Feightner; R A Hayward; K A Skarupski; S J Katz
Journal:  J Gen Intern Med       Date:  1998-04       Impact factor: 5.128

5.  Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations.

Authors:  J M Grimshaw; I T Russell
Journal:  Lancet       Date:  1993-11-27       Impact factor: 79.321

6.  Family physicians' disagreements with the US Preventive Services Task Force recommendations.

Authors:  S J Zyzanski; K C Stange; R Kelly; S Flocke; J C Shank; J Chao; C R Jaén; C K Smith
Journal:  J Fam Pract       Date:  1994-08       Impact factor: 0.493

7.  Perspective. The annual physical: what should we be doing?

Authors:  P Grantham
Journal:  Can Med Assoc J       Date:  1983-02-01       Impact factor: 8.262

8.  Preventive practice among primary care physicians in British Columbia: relation to recommendations of the Canadian Task Force on the Periodic Health Examination.

Authors:  H E Smith; C P Herbert
Journal:  CMAJ       Date:  1993-12-15       Impact factor: 8.262

9.  Determinants of primary medical practice in adult cancer prevention.

Authors:  R N Battista; J I Williams; L A MacFarlane
Journal:  Med Care       Date:  1986-03       Impact factor: 2.983

Review 10.  The Health Belief Model: a decade later.

Authors:  N K Janz; M H Becker
Journal:  Health Educ Q       Date:  1984
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  18 in total

Review 1.  How do patients' treatment preferences compare with those of clinicians?

Authors:  A A Montgomery; T Fahey
Journal:  Qual Health Care       Date:  2001-09

2.  Current awareness in Canada of clinical practice guidelines for colorectal cancer screening.

Authors:  Tracey K Asano; Daniel Toma; Hartley S Stern; Robin S McLeod
Journal:  Can J Surg       Date:  2004-04       Impact factor: 2.089

3.  The involvement of gynaecological patients in the development of a clinical guideline for resumption of (work) activities in the Netherlands.

Authors:  Carina A C M Pittens; Antonie Vonk Noordegraaf; Saskia C van Veen; Johannes R Anema; Judith A F Huirne; Jacqueline E W Broerse
Journal:  Health Expect       Date:  2013-08-29       Impact factor: 3.377

4.  Preventive care checklist form. Evidence-based tool to improve preventive health care during complete health assessment of adults.

Authors:  Vinita Dubey; Richard Glazier
Journal:  Can Fam Physician       Date:  2006-01       Impact factor: 3.275

Review 5.  Thou shalt versus thou shalt not: a meta-synthesis of GPs' attitudes to clinical practice guidelines.

Authors:  Benedicte Carlsen; Claire Glenton; Catherine Pope
Journal:  Br J Gen Pract       Date:  2007-12       Impact factor: 5.386

6.  Patients' anxiety and expectations: how they influence family physicians' decisions to order cancer screening tests.

Authors:  Jeannie Haggerty; Fred Tudiver; Judith Belle Brown; Carol Herbert; Antonio Ciampi; Remi Guibert
Journal:  Can Fam Physician       Date:  2005-12       Impact factor: 3.275

7.  Breast self-examination: resistance to change.

Authors:  M Elisabeth Del Giudice; David Tannenbaum; Pamela J Goodwin
Journal:  Can Fam Physician       Date:  2005-05       Impact factor: 3.275

8.  Comparative trial of a short workshop designed to enhance appropriate use of screening tests by family physicians.

Authors:  Marie-Dominique Beaulieu; Michèle Rivard; Eveline Hudon; Claude Beaudoin; Danielle Saucier; Martine Remondin
Journal:  CMAJ       Date:  2002-11-26       Impact factor: 8.262

9.  The ethics of type 1 diabetes prediction and prevention research.

Authors:  Lainie Friedman Ross
Journal:  Theor Med Bioeth       Date:  2003

10.  Guidelines; from foe to friend? Comparative interviews with GPs in Norway and Denmark.

Authors:  Benedicte Carlsen; Pia K Kjellberg
Journal:  BMC Health Serv Res       Date:  2010-01-16       Impact factor: 2.655

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