Format

Send to

Choose Destination
GMS Z Med Ausbild. 2012;29(3):Doc46. doi: 10.3205/zma000816. Epub 2012 May 15.

Barriers to guideline implementation and educational needs of general practitioners regarding heart failure: a qualitative study.

Author information

1
University Hospital Heidelberg, Department of General Practice and Health Services Research, Heidelberg, Germany.

Abstract

OBJECTIVES:

A clinical practice guideline (CPG) contains specifically developed recommendations that can serve physicians as a decision aid in evidence-based practice. The implementation of heart failure (HF) CPGs represents a challenge in general practice. As part of the development of a tailored curriculum, aim of this study was to identify barriers of guideline adherence and needs for medical education (CME) in HF care.

METHODS:

We conducted a modified focus group with elements of a workshop of three hours duration. Thirteen GPs collected and discussed together and parallel in smaller groups barriers of guideline implementation. Afterwards they performed a needs assessment for a tailored CME curriculum for chronic HF. The content of the discussions was analysed qualitatively according to Mayring and categorised thematically.

RESULTS:

Barriers of guideline adherence were found in the following areas: doctor: procedural knowledge (knowledge gaps), communicative and organisational skills (e.g. time management) and attitude (dissatisfaction with time-money-relation).

PATIENTS:

individual case-related problems (multimorbidity, psychiatric comorbidity, expectations and beliefs). Doctor and patient: Adherence and barriers of communication. Main measures for improvement of care concerned the areas of the identified barriers of guideline adherence with the focus on application-oriented training of the abovementioned procedural knowledge and skills, but also the supply of tools (like patient information leaflets) and patient education.

CONCLUSION:

For a CME-curriculum for HF tailored to the needs of GPs, a comprehensive educational approach seems necessary. It should be broad-based and include elements of knowledge and skills to be addressed and trained case-related. Additional elements should include support in the implementation of organisational processes in the practice and patient education.

KEYWORDS:

clinical practice guidelines; continuing medical education; family practice; heart failure; qualitative research

PMID:
22737201
PMCID:
PMC3374142
DOI:
10.3205/zma000816
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for German Medical Science GMS Publishing House Icon for PubMed Central
Loading ...
Support Center