Views of general practitioners on the use of STOPP&START in primary care: a qualitative study.

IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Acta Clinica Belgica Pub Date : 2014-08-01 Epub Date: 2014-05-29 DOI:10.1179/2295333714Y.0000000036
O Dalleur, J-M Feron, A Spinewine
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引用次数: 20

Abstract

Background and objective: STOPP (Screening Tool of Older Person's Prescriptions) and START (Screening Tool to Alert Doctors to Right Treatment) criteria aim at detecting potentially inappropriate prescribing in older people. The objective was to explore general practitioners' (GPs) perceptions regarding the use of the STOPP&START tool in their practice.

Design: We conducted three focus groups which were conveniently sampled. Vignettes with clinical cases were provided for discussion as well as a full version of the STOPP&START tool. Knowledge, strengths and weaknesses of the tool and its implementation were discussed. Two researchers independently performed content analysis, classifying quotes and creating new categories for emerging themes.

Results: Discussions highlighted incentives (e.g. systematic procedure for medication review) and barriers (e.g. time-consuming application) influencing the use of STOPP&START in primary care. Usefulness, comprehensiveness, and relevance of the tool were also questioned. Another important category emerging from the content analysis was the projected use of the tool. The GPs imagined key elements for the implementation in daily practice: computerized clinical decision support system, education, and multidisciplinary collaborations, especially at care transitions and in nursing homes.

Conclusion: Despite variables views on the usefulness, comprehensiveness, and relevance of STOPP&START, GPs suggest the implementation of this tool in primary care within computerized clinical decision support systems, through education, and used as part of multidisciplinary collaborations.

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全科医生对在初级保健中使用STOPP&START的看法:一项定性研究。
背景与目的:STOPP(老年人处方筛选工具)和START(提醒医生正确治疗的筛选工具)标准旨在发现老年人可能不适当的处方。目的是探讨全科医生(gp)对在实践中使用STOPP&START工具的看法。设计:我们进行了三个焦点小组的抽样调查。提供了临床病例的小片段以供讨论,以及完整版本的STOPP&START工具。讨论了该工具的知识、优缺点及其实现。两名研究人员独立进行了内容分析,对引用进行了分类,并为新兴主题创建了新的类别。结果:讨论强调了影响在初级保健中使用STOPP&START的激励因素(例如药物审查的系统程序)和障碍(例如耗时的应用)。该工具的有用性、全面性和相关性也受到质疑。从内容分析中出现的另一个重要类别是工具的预期使用。全科医生设想了在日常实践中实施的关键要素:计算机临床决策支持系统、教育和多学科合作,特别是在护理过渡和养老院。结论:尽管对STOPP&START的有用性、全面性和相关性有不同的看法,但全科医生建议在计算机临床决策支持系统中实施该工具,通过教育,并作为多学科合作的一部分。
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来源期刊
Acta Clinica Belgica
Acta Clinica Belgica MEDICINE, GENERAL & INTERNAL-
CiteScore
3.50
自引率
0.00%
发文量
44
期刊介绍: Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine primarily publishes papers on clinical medicine, clinical chemistry, pathology and molecular biology, provided they describe results which contribute to our understanding of clinical problems or describe new methods applicable to clinical investigation. Readership includes physicians, pathologists, pharmacists and physicians working in non-academic and academic hospitals, practicing internal medicine and its subspecialties.
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