Drugs to support smoking cessation in UK general practice: are evidence based guidelines being followed?

BackgroundDue to the COVID-19 pandemic, use of telehealth has expanded rapidly. However, little is known about the impact of delivering care through telehealth on communication between clinicians and patients. At an interactional level, the ways in which clinicians establish rapport and connection with their patients in telehealth consultations is not well understood.AimThis study will explore interactional practices of general practitioners (GPs) and patients in telehealth consultations to develop evidence-based resources to improve communication.Design & settingThe study will be conducted within the Australian general practice setting.MethodConversation analysis and sociolinguistic discourse analysis of recorded telehealth consultations will provide direct evidence of specific elements contributing to successful and less successful instances of telehealth communication. This analysis will be complemented by co-design techniques such as qualitative and reflective interviews and collaborative workshops with telehealth users, including both general practitioners and patients.ConclusionEffective communication is critical for telehealth consultations and is central to achieving optimal clinical outcomes and patient satisfaction. This study will co-develop with end-users, evidence-based guidelines encompassing effective telehealth communication strategies.

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Evidence-based guidelines for the management of genital chlamydial infection in general practice

Family Practice ◽

10.1093/fampra/16.3.269 ◽

1999 ◽

Vol 16 (3) ◽

pp. 269-277 ◽

Cited By ~ 3

Author(s):

T. Stokes

Keyword(s):

General Practice ◽

Chlamydial Infection ◽

Evidence Based ◽

Evidence Based Guidelines

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Adherence of popular smoking cessation mobile applications to evidence-based guidelines

BMC Public Health ◽

10.1186/s12889-019-7084-7 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Nikita B. Rajani ◽

Dominik Weth ◽

Nikolaos Mastellos ◽

Filippos T. Filippidis

Keyword(s):

Smoking Cessation ◽

Mobile Applications ◽

Evidence Based ◽

Evidence Based Guidelines

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Multiplicity and complexity: a qualitative exploration of influences on prescribing in UK general practice

BMJ Open ◽

10.1136/bmjopen-2020-041460 ◽

2021 ◽

Vol 11 (1) ◽

pp. e041460

Author(s):

Mary Carter ◽

Sarah Chapman ◽

Margaret C Watson

Keyword(s):

General Practice ◽

Focus Group ◽

Evidence Based ◽

Key Informants ◽

Telephone Interviews ◽

Shared Beliefs ◽

Practice Culture ◽

Unwarranted Variation ◽

Evidence Based Guidelines ◽

Qualitative Exploration

ObjectivesDespite widespread availability of evidence-based guidelines to inform rational use of medicines, considerable unwarranted variation exists in prescribing. A greater understanding of key determinants of contemporary prescribing in UK general practice could inform strategies to promote evidence-based prescribing. This study explored (1) current influences on prescribing in general practice and (2) the possibility that general practice-based pharmacists (PBPs) may contribute to greater engagement with evidence-based prescribing.DesignSemistructured, telephone interviews and a focus group were conducted, audio-recorded and transcribed verbatim. Thematic analysis was undertaken.ParticipantsGeneral practice prescribers: general practitioners (GPs), PBPs, nurses.Key informants: individuals within the National Health Service (NHS) with responsibility for influencing, monitoring and measuring general practice prescribing.SettingGeneral practices and NHS organisations in England.ResultsInterviews with 17 prescribers (GPs (n=6), PBPs (n=6), nurses (n=5)) and 6 key informants, and one focus group with five key informants were undertaken between November 2018 and April 2019. Determinants operating at individual, practice and societal levels impacted prescribing and guideline use. Prescribers’ professional backgrounds, for example, nursing, pharmacy, patient populations and patient pressure were perceived as substantial influences, as well as media portrayal and public perceptions of medicines.Prescribers identified practice-level determinants of prescribing, including practice culture and shared beliefs. Key informants tended to emphasise higher-level influences, including NHS policies, availability of support and advice from secondary care and generic challenges associated with medicines use, for example, multimorbidity.Participants expressed mixed views about the potential of PBPs to promote evidence-based prescribing in general practice.ConclusionPrescribing in UK general practice is influenced by multiple intersecting factors. Strategies to promote evidence-based prescribing should target modifiable influences at practice and individual levels. Customising strategies for medical and non-medical prescribers may maximise their effectiveness.

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Back to Back: Adherence to evidence-based guidelines is the key to improved health outcomes for general practice patients: No

Journal of Primary Health Care ◽

10.1071/hc12158 ◽

2012 ◽

Vol 4 (2) ◽

pp. 158 ◽

Cited By ~ 5

Author(s):

Dee Mangin

Keyword(s):

General Practice ◽

Health Outcomes ◽

Evidence Based ◽

Evidence Based Guidelines

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Compliance with pathology testing guidelines in Australian general practice: protocol for a secondary analysis of electronic health record data

BMJ Open ◽

10.1136/bmjopen-2018-024223 ◽

2018 ◽

Vol 8 (11) ◽

pp. e024223 ◽

Cited By ~ 2

Author(s):

Gorkem Sezgin ◽

Andrew Georgiou ◽

Rae-Anne Hardie ◽

Ling Li ◽

Lisa G Pont ◽

...

Keyword(s):

General Practice ◽

General Practitioners ◽

Evidence Based ◽

Department Of Health ◽

General Practices ◽

Electronic Health ◽

Haemoglobin Testing ◽

Evidence Based Guidelines ◽

The Impact ◽

Test Ordering

IntroductionIn Australia, general practitioners usually are the first point of contact for patients with non-urgent medical conditions. Appropriate and efficient utilisation of pathology tests by general practitioners forms a key part of diagnosis and monitoring. However overutilisationand underutilisation of pathology tests have been reported across several tests and conditions, despite evidence-based guidelines outlining best practice in pathology testing. There are a limited number of studies evaluating the impact of these guidelines on pathology testing in general practice. The aim of our quantitative observational study is to define how pathology tests are used in general practice and investigate how test ordering practices align with evidence-based pathology guidelines.Methods and analysisAccess to non-identifiable patient data will be obtained through electronic health records from general practices across three primary health networks in Victoria, Australia. Numbers and characteristics of patients, general practices, encounters, pathology tests and problems managed over time will be described. Overall rates of encounters and tests, alongside more detailed investigation between subcategories (encounter year, patient’s age, gender, and location and general practice size), will also be undertaken. To evaluate how general practitioner test ordering coincides with evidence-based guidelines, five key candidate indicators will be investigated: full blood counts for patients on clozapine medication; international normalised ratio measurements for patients on warfarin medication; glycated haemoglobin testing for monitoring patients with diabetes; vitamin D testing; and thyroid function testing.Ethics and disseminationEthics clearance to collect data from general practice facilities has been obtained by the data provider from the RACGP National Research and Evaluation Ethics Committee (NREEC 17–008). Approval for the research group to use these data has been obtained from Macquarie University (5201700872). This study is funded by the Australian Government Department of Health Quality Use of Pathology Program (Agreement ID: 4-2QFVW4M). Findings will be reported to the Department of Health and disseminated in peer-reviewed academic journals and presentations (national and international conferences, industry forums).

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