Factors influencing adherence to guidelines in general practice

Int J Technol Assess Health Care. 2003 Summer;19(3):546-54. doi: 10.1017/s0266462303000497.

Abstract

Objectives: To identify and assess the effects of general practitioner and patient characteristics on global adherence to pharmacotherapeutic guidelines.

Methods: In a cross-sectional study in the northern Netherlands, a two-level multilevel model was applied to patients (n = 269,067) in 190 practices with a total of 251 general practitioners. The dependent variable was the global adherence to pharmacotherapeutic guidelines as a measure of good prescribing in a general practice setting.

Results: The mean global adherence was 82%. Two general practice variables, organization form and degree of urbanization influenced the global adherence, whereas all patient variables (age and gender) and the patient-related prescription characteristics (costs, volume, different ATC-codes) were significant predictors for the global adherence. The total explained variance was 28%.

Conclusions: Patient characteristics have a greater influence on prescribing behavior than general practitioner characteristics.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Decision Making, Organizational
  • Drug Prescriptions
  • Drug Utilization / standards*
  • Family Practice / standards*
  • Female
  • Guideline Adherence*
  • Health Services Research
  • Humans
  • Male
  • Middle Aged
  • Models, Statistical
  • Netherlands
  • Practice Guidelines as Topic*
  • Practice Patterns, Physicians' / standards*