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Developing a computer delivered, theory based intervention for guideline implementation in general practice

Developing a computer delivered, theory based intervention for guideline implementation in general practice
Developing a computer delivered, theory based intervention for guideline implementation in general practice
Background: non-adherence to clinical guidelines has been identified as a consistent finding in general practice. The purpose of this study was to develop theory-informed, computer-delivered interventions to promote the implementation of guidelines in general practice. Specifically, our aim was to develop computer-delivered prompts to promote guideline adherence for antibiotic prescribing in respiratory tract infections (RTIs), and adherence to recommendations for secondary stroke prevention.

Methods: a qualitative design was used involving 33 face-to-face interviews with general practitioners (GPs). The prompts used in the interventions were initially developed using aspects of social cognitive theory, drawing on nationally recommended standards for clinical content. The prompts were then presented to GPs during interviews, and iteratively modified and refined based on interview feedback. Inductive thematic analysis was employed to identify responses to the prompts and factors involved in the decision to use them.

Results: GPs reported being more likely to use the prompts if they were perceived as offering support and choice, but less likely to use them if they were perceived as being a method of enforcement. Attitudes towards using the prompts were also related to anticipated patient outcomes, individual prescriber differences, accessibility and presentation of prompts and acceptability of guidelines. Comments on the prompts were largely positive after modifying them based on participant feedback.

Conclusions: acceptability and satisfaction with computer-delivered prompts to follow guidelines may be increased by working with practitioners to ensure that the prompts will be perceived as valuable tools that can support GPs' practice
1471-2296
90-[10pp]
McDermott, Lisa
5e895229-decd-4a30-8d08-dd9cc5b8f443
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Ashworth, Mark
51302b16-d1e8-4221-a192-04aebdd16f77
Gulliford, Martin
f6866310-c305-464b-92e2-e69bed8d55ef
Research Team, eCRT
fa268086-96ef-4e95-acf9-4be362828f7b
McDermott, Lisa
5e895229-decd-4a30-8d08-dd9cc5b8f443
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Ashworth, Mark
51302b16-d1e8-4221-a192-04aebdd16f77
Gulliford, Martin
f6866310-c305-464b-92e2-e69bed8d55ef
Research Team, eCRT
fa268086-96ef-4e95-acf9-4be362828f7b

McDermott, Lisa, Yardley, Lucy, Little, Paul, Ashworth, Mark, Gulliford, Martin and Research Team, eCRT (2010) Developing a computer delivered, theory based intervention for guideline implementation in general practice. BMC Family Practice, 11 (90), 90-[10pp]. (doi:10.1186/1471-2296-11-90).

Record type: Article

Abstract

Background: non-adherence to clinical guidelines has been identified as a consistent finding in general practice. The purpose of this study was to develop theory-informed, computer-delivered interventions to promote the implementation of guidelines in general practice. Specifically, our aim was to develop computer-delivered prompts to promote guideline adherence for antibiotic prescribing in respiratory tract infections (RTIs), and adherence to recommendations for secondary stroke prevention.

Methods: a qualitative design was used involving 33 face-to-face interviews with general practitioners (GPs). The prompts used in the interventions were initially developed using aspects of social cognitive theory, drawing on nationally recommended standards for clinical content. The prompts were then presented to GPs during interviews, and iteratively modified and refined based on interview feedback. Inductive thematic analysis was employed to identify responses to the prompts and factors involved in the decision to use them.

Results: GPs reported being more likely to use the prompts if they were perceived as offering support and choice, but less likely to use them if they were perceived as being a method of enforcement. Attitudes towards using the prompts were also related to anticipated patient outcomes, individual prescriber differences, accessibility and presentation of prompts and acceptability of guidelines. Comments on the prompts were largely positive after modifying them based on participant feedback.

Conclusions: acceptability and satisfaction with computer-delivered prompts to follow guidelines may be increased by working with practitioners to ensure that the prompts will be perceived as valuable tools that can support GPs' practice

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1471-2296-11-90.pdf - Other
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More information

Published date: November 2010

Identifiers

Local EPrints ID: 180145
URI: http://eprints.soton.ac.uk/id/eprint/180145
ISSN: 1471-2296
PURE UUID: 8c56ef47-2793-4f03-a0e5-6d3855335b38
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X

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Date deposited: 06 Apr 2011 10:59
Last modified: 08 Jan 2022 02:49

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Contributors

Author: Lisa McDermott
Author: Lucy Yardley ORCID iD
Author: Paul Little
Author: Mark Ashworth
Author: Martin Gulliford
Author: eCRT Research Team

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