Factors Influencing Adherence to Guidelines in General Practice

Overview

Journal Int J Technol Assess Health Care

Publisher Cambridge University Press

Specialties Biotechnology
Health Services

Date 2003 Sep 10

PMID 12962342

Citations 13

Authors

Roy E Stewart

Sebastiaan Vroegop

Gerard B Kamps

Ger Th van der Werf

Betty Meyboom-de Jong

Affiliations

Soon will be listed here.

Abstract

Objectives: To identify and assess the effects of general practitioner and patient characteristics on global adherence to pharmacotherapeutic guidelines.

Methods: In a cross-sectional study in the northern Netherlands, a two-level multilevel model was applied to patients (n = 269,067) in 190 practices with a total of 251 general practitioners. The dependent variable was the global adherence to pharmacotherapeutic guidelines as a measure of good prescribing in a general practice setting.

Results: The mean global adherence was 82%. Two general practice variables, organization form and degree of urbanization influenced the global adherence, whereas all patient variables (age and gender) and the patient-related prescription characteristics (costs, volume, different ATC-codes) were significant predictors for the global adherence. The total explained variance was 28%.

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

Citing Articles

Evaluation of the German living guideline "Protection against the Overuse and Underuse of Health Care" - an online survey among German GPs.

Warkentin L, Scherer M, Kuhlein T, Pausch F, Luhmann D, Muche-Borowski C BMC Prim Care. 2024; 25(1):414.

PMID: 39668346 PMC: 11636051. DOI: 10.1186/s12875-024-02657-1.

Utilization of clinical practice guideline on antimicrobial in China: an exploratory survey on multilevel determinants.

Deng Q, Liu W BMC Health Serv Res. 2020; 20(1):282.

PMID: 32252756 PMC: 7137508. DOI: 10.1186/s12913-020-05171-z.

Associations between workplace affiliation and phlebotomy practices regarding patient identification and test request handling practices in primary healthcare centres: a multilevel model approach.

Nilsson K, Juthberg C, Soderberg J, Bolenius K, Grankvist K, Brulin C BMC Health Serv Res. 2015; 15:503.

PMID: 26552430 PMC: 4640357. DOI: 10.1186/s12913-015-1157-9.

Swedish general practitioners' attitudes towards treatment guidelines - a qualitative study.

Milos V, Westerlund T, Midlov P, Strandberg E BMC Fam Pract. 2014; 15:199.

PMID: 25511989 PMC: 4276045. DOI: 10.1186/s12875-014-0199-0.

What are the key ingredients for effective public involvement in health care improvement and policy decisions? A randomized trial process evaluation.

Boivin A, Lehoux P, Burgers J, Grol R Milbank Q. 2014; 92(2):319-50.

PMID: 24890250 PMC: 4089374. DOI: 10.1111/1468-0009.12060.