Influences on general practitioners' use of pre-hospital thrombolysis

a qualitative study

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background The aim of the study was to determine factors influencing general practitioners' (GPs') decisions to provide pre-hospital thrombolysis for acute myocardial infarction.

Method Semi-structured, face-to-face interviews were carried out with 21 GPs in Grampian ( 10 rural; 11 urban).

Results The GPs believed that thrombolysis has an important role in the management of acute myocardial infarction, but urban practitioners were not convinced that time savings could be made by GP provision. Practical issues such as taking an electrocardiogram, ascertaining contra-indications in patients, maintaining skills, equipment, and workload were barriers preventing the provision of pre-hospital thrombolysis. There was a sense that primary care needed to feel that it is initiating change rather than having change thrust upon it.

Conclusion Decision-making processes in primary care are complex, even when the evidence supporting change is strong. Health service planners wishing to implement successful change need to consider other issues such as practical matters, support structures, current morale and practitioner perceptions of control.

Original languageEnglish
Pages (from-to)38-41
Number of pages3
JournalJournal of Public Health
Volume26
Issue number1
DOIs
Publication statusPublished - 2004

Keywords

  • thrombolysis
  • general practice
  • myocardial infarction
  • community
  • ACUTE MYOCARDIAL-INFARCTION
  • CLINICAL-PRACTICE
  • MANAGEMENT
  • GUIDELINES

Cite this

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title = "Influences on general practitioners' use of pre-hospital thrombolysis: a qualitative study",
abstract = "Background The aim of the study was to determine factors influencing general practitioners' (GPs') decisions to provide pre-hospital thrombolysis for acute myocardial infarction.Method Semi-structured, face-to-face interviews were carried out with 21 GPs in Grampian ( 10 rural; 11 urban).Results The GPs believed that thrombolysis has an important role in the management of acute myocardial infarction, but urban practitioners were not convinced that time savings could be made by GP provision. Practical issues such as taking an electrocardiogram, ascertaining contra-indications in patients, maintaining skills, equipment, and workload were barriers preventing the provision of pre-hospital thrombolysis. There was a sense that primary care needed to feel that it is initiating change rather than having change thrust upon it.Conclusion Decision-making processes in primary care are complex, even when the evidence supporting change is strong. Health service planners wishing to implement successful change need to consider other issues such as practical matters, support structures, current morale and practitioner perceptions of control.",
keywords = "thrombolysis, general practice, myocardial infarction, community, ACUTE MYOCARDIAL-INFARCTION, CLINICAL-PRACTICE, MANAGEMENT, GUIDELINES",
author = "Pauline Williams and Christine Bond and Philip Hannaford and Lewis Ritchie",
year = "2004",
doi = "10.1093/pubmed/fdh108",
language = "English",
volume = "26",
pages = "38--41",
journal = "Journal of Public Health",
issn = "1741-3842",
publisher = "Oxford University Press",
number = "1",

}

TY - JOUR

T1 - Influences on general practitioners' use of pre-hospital thrombolysis

T2 - a qualitative study

AU - Williams, Pauline

AU - Bond, Christine

AU - Hannaford, Philip

AU - Ritchie, Lewis

PY - 2004

Y1 - 2004

N2 - Background The aim of the study was to determine factors influencing general practitioners' (GPs') decisions to provide pre-hospital thrombolysis for acute myocardial infarction.Method Semi-structured, face-to-face interviews were carried out with 21 GPs in Grampian ( 10 rural; 11 urban).Results The GPs believed that thrombolysis has an important role in the management of acute myocardial infarction, but urban practitioners were not convinced that time savings could be made by GP provision. Practical issues such as taking an electrocardiogram, ascertaining contra-indications in patients, maintaining skills, equipment, and workload were barriers preventing the provision of pre-hospital thrombolysis. There was a sense that primary care needed to feel that it is initiating change rather than having change thrust upon it.Conclusion Decision-making processes in primary care are complex, even when the evidence supporting change is strong. Health service planners wishing to implement successful change need to consider other issues such as practical matters, support structures, current morale and practitioner perceptions of control.

AB - Background The aim of the study was to determine factors influencing general practitioners' (GPs') decisions to provide pre-hospital thrombolysis for acute myocardial infarction.Method Semi-structured, face-to-face interviews were carried out with 21 GPs in Grampian ( 10 rural; 11 urban).Results The GPs believed that thrombolysis has an important role in the management of acute myocardial infarction, but urban practitioners were not convinced that time savings could be made by GP provision. Practical issues such as taking an electrocardiogram, ascertaining contra-indications in patients, maintaining skills, equipment, and workload were barriers preventing the provision of pre-hospital thrombolysis. There was a sense that primary care needed to feel that it is initiating change rather than having change thrust upon it.Conclusion Decision-making processes in primary care are complex, even when the evidence supporting change is strong. Health service planners wishing to implement successful change need to consider other issues such as practical matters, support structures, current morale and practitioner perceptions of control.

KW - thrombolysis

KW - general practice

KW - myocardial infarction

KW - community

KW - ACUTE MYOCARDIAL-INFARCTION

KW - CLINICAL-PRACTICE

KW - MANAGEMENT

KW - GUIDELINES

U2 - 10.1093/pubmed/fdh108

DO - 10.1093/pubmed/fdh108

M3 - Article

VL - 26

SP - 38

EP - 41

JO - Journal of Public Health

JF - Journal of Public Health

SN - 1741-3842

IS - 1

ER -