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Determinants of adherence to recommendations for depressed elderly patients in primary care: A multi-methods study.

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Title: Determinants of adherence to recommendations for depressed elderly patients in primary care: A multi-methods study.
Authors: Aakhus, Eivind (AUTHOR), Oxman, Andrew D. (AUTHOR), Flottorp, Signe A. (AUTHOR)
Source: Scandinavian Journal of Primary Health Care. Dec2014, Vol. 32 Issue 4, p170-179. 10p.
Subjects: Mental depression, Interviewing, Research methodology, Medical personnel, Medical protocols, Patient compliance, Patients, Primary health care, Research funding, Scale analysis (Psychology), Surveys
Geographic Terms: Norway
Abstract: Objective. It is logical that tailoring implementation strategies to address identified determinants of adherence to clinical practice guidelines should improve adherence. This study aimed to identify and prioritize determinants of adherence to six recommendations for elderly patients with depression. Design and setting. Group and individual interviews and a survey were conducted in Norway. Method. Individual and group interviews with healthcare professionals and patients, and a mailed survey of healthcare professionals. A generic checklist of determinants of practice was used to categorize suggested determinants. Participants. Physicians and nurses from primary and specialist care, psychologists, researchers, and patients. Main outcome measures. Determinants of adherence to recommendations for depressed elderly patients in primary care. Results. A total of 352 determinants were identified, of which 99 were prioritized. The most frequently identified factors had to do with dissemination of guidelines, general practitioners' time constraints, the low prioritization of elderly patients with depression, and the patients' or relatives' wish for medication. Approximately three-quarters of the determinants were from three of the seven domains in the generic checklist: individual healthcare professional factors, patient factors, and incentives and resources. The survey did not provide useful information due to a low response rate and a lack of responses to open-ended questions. Implications. The list of prioritized determinants can inform the design of interventions to implement recommendations for elderly patients with depression. The importance of the determinants that were identified may vary across communities, practices. and patients. Interventions that address important determinants are necessary to improve practice. [ABSTRACT FROM AUTHOR]
Copyright of Scandinavian Journal of Primary Health Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Determinants of adherence to recommendations for depressed elderly patients in primary care: A multi-methods study.
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  Data: <searchLink fieldCode="AR" term="%22Aakhus%2C+Eivind%22">Aakhus, Eivind</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Oxman%2C+Andrew+D%2E%22">Oxman, Andrew D.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Flottorp%2C+Signe+A%2E%22">Flottorp, Signe A.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Scandinavian+Journal+of+Primary+Health+Care%22">Scandinavian Journal of Primary Health Care</searchLink>. Dec2014, Vol. 32 Issue 4, p170-179. 10p.
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  Data: <searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Interviewing%22">Interviewing</searchLink><br /><searchLink fieldCode="DE" term="%22Research+methodology%22">Research methodology</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+personnel%22">Medical personnel</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+protocols%22">Medical protocols</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+compliance%22">Patient compliance</searchLink><br /><searchLink fieldCode="DE" term="%22Patients%22">Patients</searchLink><br /><searchLink fieldCode="DE" term="%22Primary+health+care%22">Primary health care</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Scale+analysis+%28Psychology%29%22">Scale analysis (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Surveys%22">Surveys</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Norway%22">Norway</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: Objective. It is logical that tailoring implementation strategies to address identified determinants of adherence to clinical practice guidelines should improve adherence. This study aimed to identify and prioritize determinants of adherence to six recommendations for elderly patients with depression. Design and setting. Group and individual interviews and a survey were conducted in Norway. Method. Individual and group interviews with healthcare professionals and patients, and a mailed survey of healthcare professionals. A generic checklist of determinants of practice was used to categorize suggested determinants. Participants. Physicians and nurses from primary and specialist care, psychologists, researchers, and patients. Main outcome measures. Determinants of adherence to recommendations for depressed elderly patients in primary care. Results. A total of 352 determinants were identified, of which 99 were prioritized. The most frequently identified factors had to do with dissemination of guidelines, general practitioners' time constraints, the low prioritization of elderly patients with depression, and the patients' or relatives' wish for medication. Approximately three-quarters of the determinants were from three of the seven domains in the generic checklist: individual healthcare professional factors, patient factors, and incentives and resources. The survey did not provide useful information due to a low response rate and a lack of responses to open-ended questions. Implications. The list of prioritized determinants can inform the design of interventions to implement recommendations for elderly patients with depression. The importance of the determinants that were identified may vary across communities, practices. and patients. Interventions that address important determinants are necessary to improve practice. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Scandinavian Journal of Primary Health Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=101301054
RecordInfo BibRecord:
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    Identifiers:
      – Type: doi
        Value: 10.3109/02813432.2014.984961
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      – Code: eng
        Text: English
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        PageCount: 10
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    Subjects:
      – SubjectFull: Mental depression
        Type: general
      – SubjectFull: Interviewing
        Type: general
      – SubjectFull: Research methodology
        Type: general
      – SubjectFull: Medical personnel
        Type: general
      – SubjectFull: Medical protocols
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      – SubjectFull: Patient compliance
        Type: general
      – SubjectFull: Patients
        Type: general
      – SubjectFull: Primary health care
        Type: general
      – SubjectFull: Research funding
        Type: general
      – SubjectFull: Scale analysis (Psychology)
        Type: general
      – SubjectFull: Surveys
        Type: general
      – SubjectFull: Norway
        Type: general
    Titles:
      – TitleFull: Determinants of adherence to recommendations for depressed elderly patients in primary care: A multi-methods study.
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            NameFull: Aakhus, Eivind
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            NameFull: Oxman, Andrew D.
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            NameFull: Flottorp, Signe A.
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            – D: 01
              M: 12
              Text: Dec2014
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              Value: 32
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