当前位置： SCI文献检索 > JOURNAL OF GENERAL INTERNAL MEDICINE期刊下所有文献 > The adoption of preventive care practice guidelines by primary care physicians: do actions match intentions?

The adoption of preventive care practice guidelines by primary care physicians: do actions match intentions?

Abstract：

OBJECTIVE:To measure primary care physicians' familiarity with, attitudes toward, and confidence in preventive care practice guidelines for the elderly and to determine whether their attitudes are associated with implementation of guidelines into clinical practice. DESIGN:A self-administered survey of physicians employed by a health maintenance organization (HMO) and of patients cared for by those physicians. Medical records were also reviewed to assess compliance with practice guidelines. SETTING:An HMO in Southern California. PARTICIPANTS:Forty-eight primary care physicians completed the survey (100% response rate). The medical records of 3,249 randomly selected elderly patients (65 to 75 years old) were studied. Of these patients, 2,799 completed a preventive care survey (response rate 86.1%). MEASUREMENT AND RESULTS:Most HMO primary care physicians agreed or strongly agreed that guidelines will improve quality of medical care (88%) and that guidelines have caused them to change their care of patients (73%). Although the physicians' general attitudes about guidelines did not often correlate with their use of preventive care guidelines, the physicians who stated that practice guidelines had changed their practices were more likely to offer their patients clinical breast examinations (75.9% vs 67.2%, p = 0.04) and to counsel their patients to exercise (70% vs 58%, p = 0.01) than were the physicians who did not. There was a significant association between physicians' support for and adoption of specific practice guidelines regarding mammography (r = 0.34, p = 0.02) and immunizations against influenza (r = 0.42, p < 0.005), pneumococcal pneumonia (r = 0.47, p < 0.001), and tetanus (r = 0.31, p = 0.03). CONCLUSIONS:Physicians employed by an HMO were familiar with and hopeful about the role of guidelines for improving patient care. Physicians' attitudes toward specific preventive care guidelines and admission that guidelines had caused them to change their practice did at times, but not always, correlate with their implementation of guidelines into clinical practice.

journal_name

J Gen Intern Med

journal_title

Journal of general internal medicine

authors

Weingarten S,Stone E,Hayward R,Tunis S,Pelter M,Huang H,Kristopaitis R

doi

10.1007/BF02599668

subject

Has Abstract

pub_date

1995-03-01 00:00:00

pages

138-44

issue

eissn

0884-8734

issn

1525-1497

journal_volume

pub_type

杂志文章

在线工具

The adoption of preventive care practice guidelines by primary care physicians: do actions match intentions?