1. Barriers to guideline implementation and educational needs of general practitioners regarding heart failure: a qualitative study.
- Author
-
Peters-Klimm F, Natanzon I, Müller-Tasch T, Ludt S, Nikendei C, Lossnitzer N, Szecsenyi J, Herzog W, and Jünger J
- Subjects
- Adult, Curriculum, Decision Support Techniques, Education, Evidence-Based Medicine, Female, Focus Groups, Germany, Humans, Male, Needs Assessment, Physician-Patient Relations, General Practice education, Guideline Adherence, Heart Failure therapy
- 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.
- Published
- 2012
- Full Text
- View/download PDF