DESIGN: Qualitative study. GPs were interviewed after analysing two audiotaped cardiovascular consultations. SETTING: Primary health care. SUBJECTS: A sample of 15 GPs who audiotaped 22 consultations. MAIN OUTCOME MEASURES: Barriers hampering GPs from following the guideline. RESULTS: Data saturation was reached after about 13 interviews. The 25 identified barriers were related to the risk table, the GP or to environmental factors. Lack of knowledge and poor communication skills of the GP, along with pressure of work and demanding patients, cause GPs to deviate from the guideline. GPs regard barriers external to themselves as most important. CONCLUSION: Using the risk table as a key element of the high-risk approach in primary prevention encounters many barriers. Merely incorporating risk tables in guidelines is not sufficient for implementation of the guidelines. Time-efficient implementation strategies dealing in particular with the communication and presentation of cardiovascular risk are needed.
DESIGN: Qualitative study. GPs were interviewed after analysing two audiotaped cardiovascular consultations. SETTING: Primary health care. SUBJECTS: A sample of 15 GPs who audiotaped 22 consultations. MAIN OUTCOME MEASURES: Barriers hampering GPs from following the guideline. RESULTS: Data saturation was reached after about 13 interviews. The 25 identified barriers were related to the risk table, the GP or to environmental factors. Lack of knowledge and poor communication skills of the GP, along with pressure of work and demanding patients, cause GPs to deviate from the guideline. GPs regard barriers external to themselves as most important. CONCLUSION: Using the risk table as a key element of the high-risk approach in primary prevention encounters many barriers. Merely incorporating risk tables in guidelines is not sufficient for implementation of the guidelines. Time-efficient implementation strategies dealing in particular with the communication and presentation of cardiovascular risk are needed.
Authors: Cherry-Ann Waldron; John Gallacher; Trudy van der Weijden; Robert Newcombe; Glyn Elwyn Journal: BMC Med Inform Decis Mak Date: 2010-07-30 Impact factor: 2.796
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Authors: Sze Lin Yoong; Mariko Leanne Carey; Robert William Sanson-Fisher; Grant Russell; Danielle Mazza; Meredith Makeham; Christine Louise Paul; Kerry Jane Inder; Catherine D'Este Journal: BMJ Open Date: 2012-07-02 Impact factor: 2.692
Authors: France Légaré; Dawn Stacey; Susie Gagnon; Sandy Dunn; Pierre Pluye; Dominick Frosch; Jennifer Kryworuchko; Glyn Elwyn; Marie-Pierre Gagnon; Ian D Graham Journal: J Eval Clin Pract Date: 2010-08-03 Impact factor: 2.431