General Practitioner preferences and use of evidence in clinical practice: a mixed methods study

Emer O'brien, Aisling Walsh, Fiona Boland, Claire Collins, Velma Harkins, Susan Smith, Noirin O'herlihy, Barbara Clyne, Emma Wallace

Keywords: Clinical Practice Guidelines, Evidence Based Practice, Mixed methods, Patient-centred care, General Practice (Primary healthcare/Family Practice)

Introduction:

General practitioners (GPs) aim to provide patient-centred care combining clinical evidence, clinical judgement, and patient priorities. Despite availability of clinical guidelines and a recognition of the need to translate evidence to support patient care, barriers exist to the use of evidence in practice.
The aims of this study were to: 1) ascertain the needs and preferences of GPs regarding evidence-based guidance to support patient care, 2) prioritise content for future evidence-based guidance and 3) optimise evidence-based guidance structure and dissemination.

Method:

This was a convergent parallel mixed methods study. A national GP survey was administered to 3496 Irish GPs through the GP professional body (Irish College of General Practitioners) in December 2020 and GP focus groups were conducted in April/May 2021. Integration of the quantitative and qualitative findings was undertaken at the interpretive level.

Results:

A total of 509 respondents completed the survey representing a response rate of 14.6%. Seven focus groups were undertaken with 40 GP participants. Prescribing updates, interpretation of results, chronic disease management and older person care were the preferred topics for future evidence based guidance. GPs reported that they require quick access to up-to-date and relevant evidence summaries online for use in clinical practice. Access to full reviews for the purpose of continuing education and teaching was also a priority. Multiple modes of dissemination via email alerts, podcasts, videos and webinars were suggested to increase uptake of guidance in practice.

Conclusions:

To support the implementation of evidence based clinical practice, GPs require rapid access to online, up-to-date, summarised evidence-based resources. They require evidence-based guidance that reflects the disease burden of the primary care population they care for and multifaceted approaches to dissemination. Our findings support development and implementation of evidence-based guidance on prioritised topics and the use of multimodal approaches for dissemination.

#12