Department of Clinical Sciences, Family Medicine, Lund University, Malmö, Sweden.
Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden.
Scand J Prim Health Care. 2020 Mar;38(1):83-91. doi: 10.1080/02813432.2020.1717073. Epub 2020 Feb 7.
National guidelines are important instruments in reducing inappropriate antibiotic prescriptions. Low adherence to guidelines is an acknowledged problem that needs to be addressed. We evaluated established characteristics for guidelines in the guidelines for lower respiratory tract infection, acute otitis media and pharyngotonsillitis in primary care. We studied how doctors used these guidelines by analysing interviews with 29 general practitioners (GPs) in Sweden. We found important between-guidelines differences, which we believe affects adherence. The GPs reported persistent preconceptions about diagnosis and treatment, which we believe reduces their adherence to the guidelines. To increase adherence, it is important to consider doctors' preconceptions when creating new guidelines.
国家指南是减少不合理抗生素处方的重要手段。低遵从率是一个公认的问题，需要加以解决。我们评估了基层医疗中用于治疗下呼吸道感染、急性中耳炎和扁桃体咽炎的指南所具有的既定特征。我们通过分析对 29 名瑞典全科医生的访谈，研究了医生如何使用这些指南。我们发现了指南之间的重要差异，我们认为这会影响到遵从度。这些全科医生报告说，他们对诊断和治疗一直存在固有观念，这会降低他们对指南的遵从度。为了提高遵从度，在制定新的指南时，考虑医生的固有观念非常重要。
