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Elective surgical referral guidelines--background educational material or essential shared decision making tool? A survey of GPs' in England.

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  • معلومة اضافية
    • المصدر:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100967792 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2296 (Electronic) Linking ISSN: 14712296 NLM ISO Abbreviation: BMC Fam Pract Subsets: MEDLINE
    • بيانات النشر:
      Original Publication: London : BioMed Central, [2000-2021]
    • الموضوع:
      Attitude of Health Personnel* ; General Practitioners* ; Practice Guidelines as Topic*; Elective Surgical Procedures/*education ; Referral and Consultation/*standards; Adult ; Aged ; Decision Making ; England ; Female ; Humans ; Male ; Middle Aged ; Surveys and Questionnaires
    • نبذة مختصرة :
      Background: To investigate general practitioners' (GPs') attitudes to guidelines for elective surgical referral in England. To understand their use of guidelines, and attitudes to shared decision making in the referral decision.
      Methods: A questionnaire was developed which investigated attitudes to and use of guidelines. It was given to a stratified random sample 30% (n = 310) drawn from GP lists of 10 English health districts (primary care trusts (PCTs)). GPs were invited to respond online, by telephone, fax or post. Data were analysed using descriptive statistics and backwards stepwise logistic regression.
      Results: Responses were representative of GPs in England, but (despite up to 6 contacts per non-responder) the overall response rate was 41.6% (n = 129; with the range across PCTs of 25-61%). Most responding GPs indicated support for referral guidelines but 18% reported that they had never used them. Less than three per cent reported use for most or all referral decisions. The odds of using guidelines decreased with increasing age, with a ten year increase in age associated with halving odds of use (OR = 0.53, 95%CI = 0.29-0.90). Over 50% of GPs wanted good access to electronic guidelines with expert information and advice on guideline availability. Almost all (>89%) GPs agreed with sharing referral decisions with patients. Female doctors (OR = 5.2, 95%CI: 1.02-26.3) were more likely to agree with this than male GPs as were those working in larger compared to small or single handed practices (OR = 5.3, 95%CI: 1.4-19.9).
      Conclusions: This group of responding GPs was supportive of guidelines but used them in different ways. Referral guidelines should have an educational component for background reading; include key messages for internalisation and application; and incorporate mechanisms to facilitate accessibility and appropriate shared decision making with patients.
    • References:
      Fam Pract. 1998 Apr;15(2):105-11. (PMID: 9613476)
      J Eval Clin Pract. 2004 Aug;10(3):431-7. (PMID: 15304143)
      Qual Health Care. 2001 Dec;10(4):229-37. (PMID: 11743152)
      Fam Pract. 2000 Dec;17(6):462-71. (PMID: 11120716)
      Implement Sci. 2009 Oct 20;4:68. (PMID: 19840400)
      J Health Serv Res Policy. 2008 Apr;13(2):79-84. (PMID: 18416912)
      Cochrane Database Syst Rev. 2008 Jul 16;(3):CD004398. (PMID: 18646106)
      JAMA. 1999 Oct 20;282(15):1458-65. (PMID: 10535437)
      Med J Aust. 1997 Jan 20;166(2):69-72. (PMID: 9033560)
      Med Care. 2001 Aug;39(8 Suppl 2):II2-45. (PMID: 11583120)
      Patient Educ Couns. 2000 Jan;39(1):49-59. (PMID: 11013547)
      Fam Pract. 2011 Feb;28(1):68-74. (PMID: 20817791)
      Cochrane Database Syst Rev. 2009 Jul 08;(3):MR000008. (PMID: 19588449)
      J Health Serv Res Policy. 1999 Oct;4(4):215-9. (PMID: 10623037)
      Br J Gen Pract. 1994 Apr;44(381):157-62. (PMID: 8185989)
      Qual Saf Health Care. 2010 Jun;19(3):187-94. (PMID: 20211956)
      J Eval Clin Pract. 2001 May;7(2):201-10. (PMID: 11489044)
      Health Aff (Millwood). 2009 Nov-Dec;28(6):w1171-83. (PMID: 19884491)
      CMAJ. 1997 Jun 15;156(12):1705-12. (PMID: 9220922)
      Stat Med. 1998 Apr 30;17(8):873-90. (PMID: 9595617)
      Patient Educ Couns. 2002 Jul;47(3):223-7. (PMID: 12088600)
      J Eval Clin Pract. 1999 May;5(2):223-6. (PMID: 10471232)
      BMJ. 1999 Feb 20;318(7182):527-30. (PMID: 10024268)
      BMJ. 2004 Oct 30;329(7473):1013. (PMID: 15514347)
    • الموضوع:
      Date Created: 20110901 Date Completed: 20111115 Latest Revision: 20211020
    • الموضوع:
      20240628
    • الرقم المعرف:
      PMC3176475
    • الرقم المعرف:
      10.1186/1471-2296-12-92
    • الرقم المعرف:
      21878103