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Table 4 Categories and quotations for the theme “GP-related influencing factors”

From: Swedish general practitioners’ attitudes towards treatment guidelines – a qualitative study

Category Quotations
Expectations and perceptions about existing local guidelines “… and then I feel free, that if it doesn’t work with these basic drugs, it’s not a problem to prescribe something else …”
“… it is easy to check with the list … and maybe I don’t have the same critical judgement as before, but on the other hand I save time, because I perhaps wouldn’t have had the time anyway …”
Knowledge about evidence-based prescribing “It has a lot to do with our stress, that we don’t have the time to sit and read Läkartidningen a or to look at our drugs, what there is and what the options are … it is about our time … that we actually don’t have time to do it. Instead it is easier to reach for something like this … just as you say …”
“A good thing to bring up, I think, is the new electronic medical records system, PMO, that [the prescriptions] are there, so it is very easy to prescribe a recommended drug, which is very positive”.
“I didn’t even know that the guidelines were there, where do you find them?”
Trust in development of guidelines “… then I wonder a little bit…they are after all human beings … these groups who sit and write the guideline, I mean … we don’t know how active and good the doctors in these groups are …”
“…then I wonder, why does it have to be local, does it have to be different … in every region … are the patients different?”
“The background information? Yes, it is very robust and good. If I didn’t have that book I perhaps wouldn’t have been as … satisfied or had the same confidence, because I can … read about what they considered and how the drugs work”.
“But it feels quite uncomfortable, because they’re new drugs that we’ve heard so many good things about, and they cost a lot, but you sit there and wonder … well … nobody else tries it …”
Beliefs about adherence to guidelines “A barrier would also be, as I said, a lack of options. It is a barrier to following guidelines, because you don’t know whether it will work in the next step …”
“Sometimes they come with different pills from the hospital, which they don’t need, and then we are supposed to withdraw them and prescribe the recommended ones. I can say that often the patient goes along with it, because I have the book there with the guidelines …”
“It is actually aimed at GPs; hospital doctors don’t read it.” “Sometimes it feels that they don’t know what we are doing … they are supposed to follow the guidelines for the drug … but I don’t think they do…”
“Yes, I agree with you, C … if a patient has a drug that works I don’t change it either just because they change the guidelines. Because … I don’t want to make the poor old patients more confused than they already are…”
  1. aA Swedish-language medical periodical.