Evidence map›Paper›PMID 18252073›Full record

SynthesisThe British journal of general practice : the journal of the Royal College of General Practitioners2007

Thou shalt versus thou shalt not: a meta-synthesis of GPs' attitudes to clinical practice guidelines.

Benedicte Carlsen, Claire Glenton, Catherine Pope

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The British journal of general practice : the journal of the Royal College of General Practitioners, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 112 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
112citing papers in PubMed, 15 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

112 citing papers in PubMed, 15 syntheses or guidelines pooled it.

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  7. Prevalence of systolic inter-arm differences in blood pressure for different primary care populations: systematic review and meta-analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2016
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  11. Medical wikis dedicated to clinical practice: a systematic review.Journal of medical Internet research · 2015
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52 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Benedicte CarlsenStein Rokkan Centre for Social Studies, University of Bergen, Bergen, Norway. benedicte.carlsen@rokkan.uib.no
Claire Glenton
Catherine Pope

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGPs' adherence to clinical practice guidelines is variable. Barriers to guideline implementation have been identified but qualitative studies have not been synthesised to explore what underpins these attitudes.

aimTo explore and synthesise qualitative research on GPs' attitudes to and experiences with clinical practice guidelines. DESIGN OF STUDY: Systematic review and meta-synthesis of qualitative studies.

methodPubMed, CINAHL, EMBASE, Social Science Citation Index, and Science Citation Index were used as data sources, and independent data extraction was carried out. Discrepancies were resolved by consensus. Initial thematic analysis was conducted, followed by interpretative synthesis.

resultsSeventeen studies met the inclusion criteria. Five were excluded following quality appraisal. Twelve papers were synthesised which reported research in the UK, US, Canada, and the Netherlands, and covered different clinical guideline topics. Six themes were identified: questioning the guidelines, GPs' experience, preserving the doctor-patient relationship, professional responsibility, practical issues, and guideline format. Comparative analysis and synthesis revealed that GPs' reasons for not following guidelines differed according to whether the guideline in question was prescriptive, in that it encouraged a certain type of behaviour or treatment, or proscriptive, in that it discouraged certain treatments or behaviours.

conclusionPrevious analyses of guidelines have focused on professional attitudes and organisational barriers to adherence. This synthesis suggests that the purpose of the guideline, whether its aims are prescriptive or proscriptive, may influence if and how guidelines are received and implemented.

Indexed as

Attitude of Health PersonnelFamily PracticeGuideline AdherencePractice Guidelines as TopicProfessional PracticeHumansPhysician-Patient RelationsQualitative Research

Identifiers

PMID18252073
PMCPMC2084137

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.