Dataset Information

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

ABSTRACT:

Background

GPs' adherence to clinical practice guidelines is variable. Barriers to guideline implementation have been identified but qualitative studies have not been synthesised to explore what underpins these attitudes.

Aim

To explore and synthesise qualitative research on GPs' attitudes to and experiences with clinical practice guidelines.

Design of study

Systematic review and meta-synthesis of qualitative studies.

Method

PubMed, CINAHL, EMBASE, Social Science Citation Index, and Science Citation Index were used as data sources, and independent data extraction was carried out. Discrepancies were resolved by consensus. Initial thematic analysis was conducted, followed by interpretative synthesis.

Results

Seventeen studies met the inclusion criteria. Five were excluded following quality appraisal. Twelve papers were synthesised which reported research in the UK, US, Canada, and the Netherlands, and covered different clinical guideline topics. Six themes were identified: questioning the guidelines, GPs' experience, preserving the doctor-patient relationship, professional responsibility, practical issues, and guideline format. Comparative analysis and synthesis revealed that GPs' reasons for not following guidelines differed according to whether the guideline in question was prescriptive, in that it encouraged a certain type of behaviour or treatment, or proscriptive, in that it discouraged certain treatments or behaviours.

Conclusion

Previous analyses of guidelines have focused on professional attitudes and organisational barriers to adherence. This synthesis suggests that the purpose of the guideline, whether its aims are prescriptive or proscriptive, may influence if and how guidelines are received and implemented.

SUBMITTER: Carlsen B

PROVIDER: S-EPMC2084137 | biostudies-literature | 2007 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

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

Carlsen Benedicte B Glenton Claire C Pope Catherine C

The British journal of general practice : the journal of the Royal College of General Practitioners 20071201 545

<h4>Background</h4>GPs' adherence to clinical practice guidelines is variable. Barriers to guideline implementation have been identified but qualitative studies have not been synthesised to explore what underpins these attitudes.<h4>Aim</h4>To explore and synthesise qualitative research on GPs' attitudes to and experiences with clinical practice guidelines.<h4>Design of study</h4>Systematic review and meta-synthesis of qualitative studies.<h4>Method</h4>PubMed, CINAHL, EMBASE, Social Science Cit ...[more]

PMID: 18252073

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Dataset Information

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

Background

Aim

Design of study

Method

Results

Conclusion

Publications

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

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