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Teaching young GPs to cope with psychosocial consultations without prescribing: a durable impact of an e-module on determinants of benzodiazepines prescribing
- Source :
- BMC Medical Education, BMC Medical Education, Vol 17, Iss 1, Pp 1-9 (2017), BMC medical education, BMC MEDICAL EDUCATION
- Publication Year :
- 2017
- Publisher :
- BioMed Central, 2017.
-
Abstract
- Background Despite guidelines and campaigns to change prescribing behavior, General Practitioners (GPs) continue to overprescribe benzodiazepines (BZDs). New approaches to improve prescribing are needed. Using behavior change techniques and tailoring interventions to user characteristics are vital to promote behavior change. This study evaluated the impact of an e-module on factors known to determine BZD prescribing practice. Methods A tailored e-module that focuses on avoiding initial BZD prescriptions (and using psychological interventions as an alternative) was developed and offered to GPs in vocational training. Three self-report assessments took place: at baseline, immediately after the module (short term) and at least six months after completion (long term). Assessed determinants include GPs’ attitudes concerning treatment options, perceptions of the patient and self-efficacy beliefs. Readiness to adhere to prescribing guidelines was evaluated through assessing motivation, self-efficacy and implementability of non-pharmacological interventions. Changes in determinants were analyzed using the Wilcoxon signed-rank test. Changes in readiness to adhere to guidelines was analyzed using the nonparametric McNemar Bowker test. Results A desirable, significant and durable impact on determinants of BZD prescribing was observed. GPs (n = 121) underwent desirable changes in their attitudes, perceptions and self-efficacy beliefs and these changes remained significant months after the intervention. Barriers to using a non-pharmacological approach often cited in literature remained absent and were not highlighted by the intervention. Furthermore a significant impact on GPs’ readiness to adhere to guidelines was observed. Participants reported change in their ability to cope with psychosocial consultations and to have tried using non-pharmacological interventions. Conclusions Tailoring an e-intervention to target group (GPs) characteristics appears to be successful in promoting behavioral change in GPs undertaking vocational training. Significant and lasting changes were observed in determinants of prescribing BZDs. The e-intervention resulted in a positive impact on participants’ readiness to adhere to BZD prescribing guidance and their coping with psychosocial consultations. Investigating which mechanisms of change are responsible for the observed effectiveness could help to refine and improve future interventions. Electronic supplementary material The online version of this article (10.1186/s12909-017-1100-3) contains supplementary material, which is available to authorized users.
- Subjects :
- Male
Coping (psychology)
PERCEPTIONS
A300 Clinical Medicine
Psychological intervention
lcsh:Medicine
Inappropriate Prescribing
Benzodiazepines
0302 clinical medicine
DEPENDENCE
Adaptation, Psychological
Medicine and Health Sciences
030212 general & internal medicine
Practice Patterns, Physicians'
Referral and Consultation
lcsh:LC8-6691
Changing prescribing behavior
Benzodiazepine
E-intervention
Behavior change
Behavior change methods
General Medicine
Psychological determinants of prescribing practice
EXPERIENCES
Self Efficacy
Female
Guideline Adherence
Psychosocial
BEHAVIOR
Research Article
Adult
medicine.medical_specialty
Attitude of Health Personnel
SELF-DETERMINATION
Coping with psychosocial consultations
Education
General practitioner
03 medical and health sciences
McNemar's test
General Practitioners
GENERAL-PRACTICE
MANAGEMENT
medicine
Humans
Medical prescription
METAANALYSIS
Self-efficacy
Educational sciences
Medical education
lcsh:Special aspects of education
business.industry
lcsh:R
MOTIVATION
INSOMNIA
Family medicine
Human medicine
sense organs
business
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- ISSN :
- 14726920
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- BMC Medical Education
- Accession number :
- edsair.doi.dedup.....4fc3bb448d830c88c0be98c2eae69449