ArticleBMC family practice2009
Reasons of general practitioners for not prescribing lipid-lowering medication to patients with diabetes: a qualitative study.
Article in BMC family practice, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
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Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Barriers to effective management of type 2 diabetes in primary care: qualitative systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2016Pooled it
- Cluster randomised trial on the effectiveness of a computerised prompt to refer (back) patients with type 2 diabetes.PloS one · 2018Trial
- Tensions in caring for chronic patients' medication adherence: A qualitative study in Cyprus.Journal of health psychology · 2024Article
- The Impact of an Educational Intervention on Enhancing Clinical Knowledge of Physicians and Pharmacists Regarding Statins and Monitoring Parameters: The Experience of a Tertiary Teaching Hospital.Advances in medical education and practice · 2024Article
- Article
- Utilization of statins in patients with type 2 diabetes mellitus: the practice in a lower middle income South Asian country.International journal of diabetes in developing countries · 2023Article
- Protocol for the pilot randomized trial of the CArdiovascular Risk assEssment for Rheumatoid Arthritis (CARE RA) intervention: a peer coach behavioral intervention.Pilot and feasibility studies · 2022Article
- Article
- Impact of lowering the risk threshold for statin treatment on statin prescribing: a descriptive study in English primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
- Article
- Prescribing and medical non-adherence after myocardial infarction: qualitative interviews with general practitioners in Germany.BMC family practice · 2020Article
- Time trends analysis of statin prescription prevalence, therapy initiation, dose intensity, and utilization from the hospital information system of Jinshan Hospital, Shanghai (2012-2018).BMC cardiovascular disorders · 2020Observational
- Barriers and facilitators for screening and treatment of hyperlipidemia among patients with inflammatory arthritis.BMC rheumatology · 2020Article
- Screening of Hyperlipidemia Among Patients With Rheumatoid Arthritis in the United States.Arthritis care & research · 2019Article
- Longitudinal trends and predictors of statin use among patients with diabetes.Journal of diabetes and its complications · 2018Article
- A scoping review of the potential for chart stimulated recall as a clinical research method.BMC health services research · 2017Article
- Cardiovascular Risk in HIV-Infected and Uninfected Postmenopausal Minority Women: Use of the Framingham Risk Score.Journal of women's health (2002) · 2017Article
- Under-prescribing of Prevention Drugs and Primary Prevention of Stroke and Transient Ischaemic Attack in UK General Practice: A Retrospective Analysis.PLoS medicine · 2016Article
- The potential for deprescribing in care home residents with Type 2 diabetes.International journal of clinical pharmacy · 2016Article
- Organising medication discontinuation: a qualitative study exploring the views of general practitioners toward discontinuing statins.BMC health services research · 2016Article
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4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLipid-lowering medication remains underused, even in high-risk populations. The objective of this study was to determine factors underlying general practitioners' decisions not to prescribe such drugs to patients with type 2 diabetes.
methodsA qualitative study with semi-structured interviews using real cases was conducted to explore reasons for not prescribing lipid-lowering medication after a guideline was distributed that recommended the use of statins in most patients with type 2 diabetes. Seven interviews were conducted with general practitioners (GPs) in The Netherlands, and analysed using an analytic inductive approach.
resultsReasons for not-prescribing could be divided into patient and physician-attributed factors. According to the GPs, some patients do not follow-up on agreed medication and others object to taking lipid-lowering medication, partly for legitimate reasons such as expected or perceived side effects. Furthermore, the GPs themselves perceived reservations for prescribing lipid-lowering medication in patients with short life expectancy, expected compliance problems or near goal lipid levels. GPs sometimes postponed the start of treatment because of other priorities. Finally, barriers were seen in the GPs' practice organisation, and at the primary-secondary care interface.
conclusionSome of the barriers mentioned by GPs seem to be valid reasons, showing that guideline non-adherence can be quite rational. On the other hand, treatment quality could improve by addressing issues, such as lack of knowledge or motivation of both the patient and the GP. More structured management in general practice may also lead to better treatment.
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