Background: The uptake of guideline recommendations in general practice can potentially be improved by designing implementation interventions that are tailored to prospectively identify barriers. However, there is insufficient evidence regarding the most effective and efficient approaches to tailoring. Our study provides an insight into the usefulness of tailored interventions to prospectively identified barriers affecting the uptake of guideline recommendations for anxiety and depressive disorders experienced by general practitioners (GPs) in their local context.
Methods: A qualitative study was conducted, in which 23 GPs gave informed consent and 14 finally participated. To explore the barriers affecting the uptake of guideline recommendations, a face-to-face interview was conducted with each GP to generate a personalised list. In response to this list, interventions were tailored to remove the barriers experienced by the GPs. To examine the perceived usefulness of the tailored interventions, telephone interviews were conducted after one year and coded through thematic coding. The analysis was descriptive in nature.
Results: The most frequently perceived barriers were: a lack of knowledge and skills, no agreement on guideline recommendations, negative outcome expectancy, low self-efficacy, no consensus with patients, and a lack of information about treatments provided by mental health professionals, together with waiting lists. The tailored interventions 'peer group supervision' and 'individualised telephone consultations' were perceived as useful by most GPs. Besides the tailored interventions, a perceived benefit of using a self-rating scale, measuring depressive and anxiety symptoms, and the idea of delivering better patient care, were supportive in the uptake of guideline recommendations.
Conclusions: Our findings suggest that tailoring interventions to prospectively identified barriers, affecting the uptake of guideline recommendations for anxiety and depressive disorders, as perceived by GPs, may enhance the implementation of these guideline recommendations.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3726506 | PMC |
| http://dx.doi.org/10.1186/1471-2296-14-94 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The role of neuropsychological assessment in the evaluation of patients with cognitive-behavioral change due to suspected Alzheimer's disease and other causes of cognitive impairment and dementia.
Alzheimers Dement
December 2024
Northwestern Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Chicago, Illinois, USA.
The Alzheimer's Association convened a Diagnostic Evaluation, Testing, Counseling and Disclosure Clinical Practice Guideline workgroup to help combat the major global health challenges surrounding the timely detection, accurate diagnosis, and appropriate disclosure of mild cognitive impairment (MCI) or dementia due to Alzheimer's disease (AD) or other diseases that cause these types of cognitive-behavioral disorders. The newly published clinical practice guidelines are proposed as a structured approach to evaluation. The purpose of the present article is to provide a clinical perspective on the use of neuropsychology within the new framework and practice guidelines outlined under the Diagnostic Evaluation, Testing, Counseling and Disclosure of Suspected Alzheimer's Disease and Related Disorders (DETeCD-ADRD) recommendations for primary care and specialty care.
View Article and Find Full Text PDFGuidance reconciliation and practice question prioritization for a World Health Organization's Ebola and Marburg Disease guideline.
J Clin Epidemiol
December 2024
Department of Internal Medicine, American University of Beirut, Beirut, Lebanon; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Objective: To describe the processes of reconciling overlapping guidance and prioritizing practice questions for a World Health Organization (WHO) guideline on Infection Prevention and Control (IPC) for Ebola and Marburg disease.
Methods: This work involved the reconciliation of guidance, the generation of potential practice questions and the prioritization of those questions. Contributors included the WHO secretariat, the WHO steering group, the guideline methodologists, and the guideline development group (GDG).
Accuracy of Electronic Health Record Phenotypes to Detect Recognition of Hypertension in Pediatric Primary Care.
Acad Pediatr
December 2024
Department of Pediatrics, Yale School of Medicine; Department of Biostatistics, Yale School of Public Health.
Objective: To evaluate the accuracy of extractable electronic health record (EHR) data to define clinician recognition of hypertension in pediatric primary care.
Methods: We used EHR data to perform a cross-sectional study of children aged 3-18 years at well-visits in Connecticut from 2018-2023 (n=50,290) that had either: (1) incident hypertension (hypertensive BP at the well-visit and ≥2 prior hypertensive BPs without prior diagnosis of hypertension); or (2) isolated hypertensive BP at the well-visit without necessarily having prior hypertensive BPs. We tested the accuracy of EHR phenotypes to detect recognition of incident hypertension or hypertensive BP using structured elements, including diagnosis codes, problem list entries, number of BP measurements, orders, and follow-up information.
Chronic kidney disease (CKD) is a common clinical condition with significant health risks for patients and is widely recognised as a major public health concern. Laboratory medicine plays a crucial role in both diagnosing and managing CKD, as diagnosis and staging rely on estimated glomerular filtration rate (GFR) and evaluating albuminuria (or proteinuria). It was evident that the laboratory assessment of CKD in Malaysia is not standardised.
View Article and Find Full Text PDFCholangiocarcinoma Targeted Therapies: Mechanisms of Action and Resistance.
Am J Pathol
December 2024
Massachusetts General Hospital Cancer Center, Krantz Family Center for Cancer Research, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. Electronic address:
Cholangiocarcinoma is an aggressive bile duct malignancy with heterogeneous genomic features. Although most patients receive standard-of-care chemotherapy/immunotherapy, genomic changes that can be targeted with established or emerging therapeutics are common. Accordingly, precision medicine strategies are transforming the next-line treatment for patient subsets.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!