Literature DB >> 8828872

Preventive care and barriers to effective prevention. How do family physicians see it?

B G Hutchison1, J Abelson, C A Woodward, G Norman.   

Abstract

OBJECTIVES: To assess how adequately family physicians think they are delivering preventive care and to examine barriers to providing preventive care.
DESIGN: Cross-sectional survey.
SETTING: Primary care medical practices in south-central Ontario. PARTICIPANTS: Four hundred eighty family physicians and general practitioners who graduated from medical school between 1972 and 1988. MAIN OUTCOME MEASURES: Satisfactory preventive care delivery versus self-assessed coverage of patients for 15 preventive maneuvers. Perceived reasons for lack of success in providing recommended preventive care.
RESULTS: For 10 of the 15 maneuvers, the proportion of physicians who regarded 90% or higher as satisfactory coverage was twice as great as the proportion who thought they provided that level of coverage. For 11 of the 15 maneuvers, most respondents reported coverage lower than the level they regarded as satisfactory. For six maneuvers, more than two thirds thought they provided less than satisfactory coverage. More than two thirds of respondents suggested these barriers to providing recommended preventive care: patient is healthy and does not visit; patient refuses, is not interested, or does not comply; no effective systems to remind patients to come in for preventive care; and priority given to presenting problem.
CONCLUSION: Many family physicians and general practitioners in south-central Ontario provide preventive care to their patients at lower levels than they consider satisfactory. They identified barriers to providing preventive services successfully; these barriers suggest approaches for improving care.

Entities:  

Mesh:

Year:  1996        PMID: 8828872      PMCID: PMC2146897     

Source DB:  PubMed          Journal:  Can Fam Physician        ISSN: 0008-350X            Impact factor:   3.275


  20 in total

1.  Improved preventive care following an intervention during an ambulatory care rotation: carryover to a second setting.

Authors:  J E Korn; L A Schlossberg; E C Rich
Journal:  J Gen Intern Med       Date:  1988 Mar-Apr       Impact factor: 5.128

2.  A five-year demonstration project associated with improvement in physician health maintenance behavior.

Authors:  J C Shank; T Powell; J Llewelyn
Journal:  Fam Med       Date:  1989 Jul-Aug       Impact factor: 1.756

3.  Quality of care in family practice: does residency training make a difference?

Authors:  A E Borgiel; J I Williams; M J Bass; E V Dunn; M K Evensen; C T Lamont; P J MacDonald; J M McCoy; R A Spasoff
Journal:  CMAJ       Date:  1989-05-01       Impact factor: 8.262

4.  Effect of medical records' checklists on implementation of periodic health measures.

Authors:  C Cheney; J W Ramsdell
Journal:  Am J Med       Date:  1987-07       Impact factor: 4.965

5.  Delayed feedback of physician performance versus immediate reminders to perform preventive care. Effects on physician compliance.

Authors:  W M Tierney; S L Hui; C J McDonald
Journal:  Med Care       Date:  1986-08       Impact factor: 2.983

6.  Improving compliance with preventive medicine procedures in a house staff training program.

Authors:  D T Schreiner; E R Petrusa; C S Rettie; R M Kluge
Journal:  South Med J       Date:  1988-12       Impact factor: 0.954

7.  Preventive care: do we practice what we preach?

Authors:  N Lurie; W G Manning; C Peterson; G A Goldberg; C A Phelps; L Lillard
Journal:  Am J Public Health       Date:  1987-07       Impact factor: 9.308

8.  Promoting cancer screening. A randomized, controlled trial of three interventions.

Authors:  S J McPhee; J A Bird; C N Jenkins; D Fordham
Journal:  Arch Intern Med       Date:  1989-08

9.  Performance of cancer screening in a university general internal medicine practice: comparison with the 1980 American Cancer Society Guidelines.

Authors:  S J McPhee; R J Richard; S N Solkowitz
Journal:  J Gen Intern Med       Date:  1986 Sep-Oct       Impact factor: 5.128

10.  Screening procedures in the asymptomatic adult. Comparison of physicians' recommendations, patients' desires, published guidelines, and actual practice.

Authors:  B Woo; B Woo; E F Cook; M Weisberg; L Goldman
Journal:  JAMA       Date:  1985-09-20       Impact factor: 56.272

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  16 in total

Review 1.  Incorporating preventive care recommendations into clinical practice: how do we bridge the gap?

Authors:  J D Douketis
Journal:  CMAJ       Date:  1999-04-20       Impact factor: 8.262

2.  Physicians Taking Action Against Smoking: an intervention program to optimize smoking cessation counselling by Montreal general practitioners.

Authors:  M Tremblay; A Gervais; C Lacroix; J O'Loughlin; H Makni; G Paradis
Journal:  CMAJ       Date:  2001-09-04       Impact factor: 8.262

Review 3.  Systematic review and meta-analysis of practice facilitation within primary care settings.

Authors:  N Bruce Baskerville; Clare Liddy; William Hogg
Journal:  Ann Fam Med       Date:  2012 Jan-Feb       Impact factor: 5.166

4.  Who delivers preventive care as recommended?: Analysis of physician and practice characteristics.

Authors:  Amardeep Thind; John Feightner; Moira Stewart; Cathy Thorpe; Andrea Burt
Journal:  Can Fam Physician       Date:  2008-11       Impact factor: 3.275

Review 5.  Cervical cancer screening.

Authors:  A Katz
Journal:  Can Fam Physician       Date:  1998-08       Impact factor: 3.275

6.  Provision of preventive care to unannounced standardized patients.

Authors:  B Hutchison; C A Woodward; G R Norman; J Abelson; J A Brown
Journal:  CMAJ       Date:  1998-01-27       Impact factor: 8.262

7.  Collaborative Cardiovascular Risk Reduction in Primary Care II (CCARP II): Implementation of a systematic case-finding process for patients with uncontrolled risk factors.

Authors:  Erin M Yakiwchuk; Derek Jorgenson; Kerry Mansell; Tessa Laubscher; Marlys Lebras; David F Blackburn
Journal:  Can Pharm J (Ott)       Date:  2013-09

8.  Mammography rates for 20 community-based family practices in Ontario: a full practice audit.

Authors:  J Graham Swanson; Janusz Kaczorowski
Journal:  Can J Public Health       Date:  2007 Sep-Oct

9.  Practice and physician characteristics associated with influenza vaccination delivery rates following a patient reminder letter intervention.

Authors:  Kelly K Anderson; Rolf J Sebaldt; Lynne Lohfeld; Ron Goeree; Faith C Donald; Ken Burgess; Janusz Kaczorowski
Journal:  J Prim Prev       Date:  2008-01-19

10.  The relationship between socio-economic factors and responsiveness gaps in primary, preventative and health promotion services.

Authors:  Yair Zalmanovitch; Dana R Vashdi
Journal:  Health Expect       Date:  2014-07-02       Impact factor: 3.377

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