Determinants of adherence to recommendations for depressed elderly patients in primary care: a
multi-methods study
Engelsk titel: Determinants of adherence to recommendations for depressed elderly patients in primary care: a
multi-methods study
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Författare:
Aakhus, Eivind
;
Oxman, Andrew D
;
Flottorp, Signe A
Email: eivind.aakhus@gmail.com
Språk: Eng
Antal referenser: 20
Dokumenttyp:
Artikel
UI-nummer: 15069367
Sammanfattning
Objective. It is logical that tailoring implementation strategies to address identified determinants
of adherence to clinical practice guidelines should improve adherence. This study aimed to identify
and prioritize determinants of adherence to six recommendations for elderly patients with
depression. Design and setting. Group and individual interviews and a survey were conducted in
Norway. Method. Individual and group interviews with healthcare professionals and patients, and a
mailed survey of healthcare professionals. A generic checklist of determinants of practice was used
to categorize suggested determinants. Participants. Physicians and nurses from primary and
specialist care, psychologists, researchers, and patients. Main outcome measures. Determinants of
adherence to recommendations for depressed elderly patients in primary care. Results. A total of 352
determinants were identified, of which 99 were prioritized. The most frequently identified factors had
to do with dissemination of guidelines, general practitioners’ time constraints, the low prioritization of
elderly patients with depression, and the patients’ or relatives’ wish for medication. Approximately
three-quarters of the determinants were from three of the seven domains in the generic checklist:
individual healthcare professional factors, patient factors, and incentives and resources. The survey
did not provide useful information due to a low response rate and a lack of responses to open-ended
questions. Implications. The list of prioritized determinants can inform the design of interventions to
implement recommendations for elderly patients with depression. The importance of the
determinants that were identified may vary across communities, practices. and patients.
Interventions that address important determinants are necessary to improve practice.