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International Journal of Technology Assessment in Health Care International Journal of Technology Assessment in Health Care

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FACTORS INFLUENCING ADHERENCE TO GUIDELINES IN GENERAL PRACTICE

Published online by Cambridge University Press:  09 September 2003

Roy E. Stewart ,
Sebastiaan Vroegop ,
Gerard B. Kamps ,
Ger Th. van der Werf  and
Betty Meyboom-de Jong
Roy E. Stewart
Affiliation:
University of Groningen
Sebastiaan Vroegop
Affiliation:
University of Groningen
Gerard B. Kamps
Affiliation:
University of Groningen
Ger Th. van der Werf
Affiliation:
University of Groningen
Betty Meyboom-de Jong
Affiliation:
University of Groningen
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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.We thank the health care insurance organization (Regionaal Ziekenfonds Groningen [RZG]) for supplying the data set. We also thank Eddie Bruin from the health care insurance organization for his assistance with data collection and Tom Snijders for data analysis and statistical advice.

Keywords

Guideline adherenceFamily practiceStatistical modelsMultilevel modelThe Netherlands
Type
RESEARCH NOTES
Information
International Journal of Technology Assessment in Health Care , Volume 19 , Issue 3 , August 2003 , pp. 546 - 554
Copyright
© 2003 Cambridge University Press

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