Table 1 Individual study characteristics
Author (Year) and country | No. of GP participants and their characteristics | Patient population and topic focus | Multimorbidity content | Method of data collection | Theoretical framework and form of analysis |
|---|---|---|---|---|---|
Ailabouni (2016a) [73] New Zealand | 10 GPs No. of years’ experience prescribing in residential care: 2–32 years | A hypothetical patient with multimorbidity Deprescribing | Focus. Uses a hypothetical patient with multimorbidity to stimulate discussion of multimorbidity | Semi-structured interviews | Theoretical Domain Framework Content analysis |
Ailabouni (2016b) [74] New Zealand | 10 GPs No. of years’ experience prescribing in residential care: 2–32 years. Gender: 7 males; 3 females | Older patients in residential aged care Deprescribing | Derived theme | Semi-structured interviews | Theoretical Domain Framework Content analysis |
Anderson (2017) [60] Australia | 32 GPs Mean age: 47 years (range: 28–70 years). Mean time in practice: 18 years (range: 1–50 years). 63.3% full-time. Gender: 18 males; 14 females. | Older patients with multimorbidity in primary care Deprescribing | Focus. Uses a hypothetical patient with multimorbidity to stimulate discussion of multimorbidity | Focus groups | Not stated Thematic analysis using Framework Method |
Austad (2016) [68] Norway | 25 GPs Not stated | Patients with multimorbidity in general practice Clinical practice guidelines | Focus | Focus groups | Phenomenological approach Systematic text condensation |
Blakeman (2012) [55] England, UK | 11 GPs Median age: 45 years (range: 30–62 years). Gender: 6 males; 5 females. | Patients with early-stage chronic kidney disease in primary care Patient management | Focus. Section on multimorbidity included in interview guide | Semi-structured interviews | Normalisation Process Theory Deductive analysis using framework |
Bower (2011) [56] England, UK | 15 GPs ‘A mix of males and females’; ‘significant variation in age and experience among participants’ | Patients with multimorbidity in general practice Service organisation; Decision making | Focus | Semi-structured interviews | Not stated Framework analysis |
Clyne (2016) [70] Ireland | 17 GPs N = 14 GPs in practice > 10 years. Gender: 13 males; 4 females | Older patients in primary care Potentially inappropriate prescribing | Derived theme | Semi-structured interviews | Not stated Thematic analysis |
Jones (2018) [61] Australia | 14 GPs Mean time in practice: 21 years. | Remote Australian Aboriginal patients with complex health problems Clinical practice guidelines | Focus | Semi-structured interviews | Critical theory and a realist paradigm Thematic analysis |
Kenning (2013) [57] England, UK | 16 GPs Mean time in practice: 17 years. Gender: 7 males; 9 females. | Patients with multimorbidity in general practice Working with patients; self-care | Focus | Semi-structured interviews | Not stated Thematic analysis |
Kristensen (2017) [64] Denmark | 12 GPs Median time in practice: 16 years (range: 1–41 years). Gender: 6 males, 6 females. | Patients with multimorbidity living in rural, socioeconomically deprived regions Self-care | Focus | Semi-structured interviews | Not stated Systematic text condensation |
Kristensen (2018) [65] Denmark | See Kristensen (2017) as duplicate data | Patients with multimorbidity and lowered self-care ability Disease management programs | Focus | Semi-structured interviews | Not stated Systematic text condensation |
Kuluski (2013) [76] Canada | 4 Family Physicians Time in practice: 3 GPs > 10 years; 1 = 1 year. | Older patients with multimorbidity in primary care Care goals | Focus | Semi-structured interviews | Not stated Thematic analysis |
Laue (2016) [69] International but only extracted data and findings for Norway, Wales, and the Netherlands | 23 GPs (Norway: n = 7; Netherlands: n = 6; Wales: n = 10) Norway. Time in practice: 2 months-20 years. Netherlands. Time in practice: 3–30 years. Wales. Time in practice: 4–28 years. | Patients with COPD and exacerbations Decision making | Derived theme | Focus groups | Grounded theory Thematic analysis |
Laursen (2018) [66] Denmark | 14 GPs Mean time in practice: 15 years. Gender: 7 males; 7 females. | Poly-medicated patients with multimorbidity Medication review | Focus | Semi-structured interviews | Phenomenological/hermeneutic orientation Content analysis |
Luijks (2012) [48] Netherlands | 25 GPs Mean age = 50 years. Mean time in practice: 20 years (range: 2–36 years). Gender: 18 males; 7 females. | Patients with multimorbidity in general practice Patient management | Focus | Focus groups | Realism paradigm Constant comparative analysis |
Luijks (2015) [49] Netherlands | See Luijks (2012) as duplicate data | Patients with multimorbidity in general practice Clinical practice guidelines | Focus | Focus groups | Not stated Constant comparative analysis |
Mc Namara (2017) [62] Australia | 5 GPs (26 health care professionals in total) Not stated | Patients with multimorbidity in general practice Patient management | Focus | Semi-structured interviews | AGS Guiding Principles (cite) used as a framework for analyis Constant comparative analysis |
O’Brien (2011) [80] Scotland, UK | 15 GPs Gender: 8 males; 7 females | Socioeconomically deprived patients with multimorbidity in general practice Patient management | Focus | Semi-structured interviews | Modified grounded theory approach Constant comparative analysis |
Ploeg (2017) [77] Canada | 4 Family Physicians Not stated | Older, community dwelling patients with multimorbidity Patient management | Focus | Semi-structured interviews | Thorne’s interpretative description approach Constant comparative analysis |
Prazeres (2016) [79] Portugal | 74 GPs Mean time in practice: 16 years (range 1–37 years). Gender: 23 males; 51 females | Patients with multimorbidity in general practice Patient management | Focus | Online survey | Not stated Thematic content analysis |
Risor (2013) [50] International but only extracted data and findings for Norway, Wales, and the Netherlands | See Laue (2016) as duplicate data | Patients with COPD and exacerbations Decision making | Derived theme | Focus groups | Grounded theory Not stated but ‘line-by-line coding’ used |
Sandelowsky (2016) [78] Sweden | 59 Primary Care Practitioners Mean age: 46 years (range 28–68 years). Mean time in practice: 14 years (range 1–39 years). Gender: 30 males; 29 females. | Patients with COPD Patient management | Focus | Semi-structured interviews and focus groups | ‘Inspired by the grounded theory method’ Constant comparative analysis |
Schuling (2012) [51] Netherlands | 29 GPs Mean age: 54 years (range 39–65 years). Gender: 27 males; 2 females. | Older patients with multimorbidity in primary care Deprescribing | Focus | Focus groups | Not stated Thematic analysis |
Sinnige (2016) [52] Netherlands | 12 GPs Mean age: 56 years (range 46–63 years). Mean time in practice: 25 years (range 10–35 years). | Older people with polypharmacy in general practice Medication management; Polypharmacy | Focus of clinical vignettes | Focus groups | Not stated Framework approach |
Sinnott (2015) [71] Ireland | 20 GPs Length of time qualified: 6 GPs < 10 years; 14 GPs > 10 years. | Patients with multimorbidity in general practice Prescribing decisions | Focus | Semi-structured interviews and chart-stimulated recall | Grounded theory approach Constant comparative analysis |
Smith (2010) [72] Ireland | 13 GPs Not stated | Patients with multimorbidity in general practice Patient management | Focus | Focus group | Not stated Framework analysis |
Solomon (2012) [58] England, UK | 8 GPs Not stated | Patients prescribed a statin or a PPI in primary care Clinical practice guidelines; Patient-GP partnership | Derived theme | Semi-structured interviews | Not stated Framework analysis |
Sondergaard (2015) [67] Nordic countries: Denmark, Finland, Iceland, Norway, Sweden | 62 GPs Not stated | Patients with multimorbidity in general practice Patient management | Focus | Plenary session and short open-ended questionnaires | Not stated Framework analysis |
Stanners (2012) [63] Australia | 8 GPs Time in practice (range): 20–40 years. Gender: 7 males; 1 female. | Patients with multimorbidity and depression in general practice Patient management | Focus | Semi-structured interviews | Grounded theory Constant comparative analysis |
Stokes (2017) [75] New Zealand | 12 GPs Not stated | Patients with multimorbidity in general practice Patient management | Focus | Semi-structured interviews | Not stated Thematic analysis |
Tonkin-Crine (2015) [59] England, UK | 19 GPs Mean age: 46 years (range: 31–60 years). Mean time in practice: 16 years (range: 3–32 years). Gender: 12 males; 7 females. | Patients with advanced chronic kidney disease in primary care Patient management | Derived theme | Semi-structured interviews | Not stated Thematic analysis |
van de Pol (2015) [53] Netherlands | 20 GPs Mean age: 48 years (range: 32–60 years). Gender: 11 males; 9 females. | Older patients in residential aged care Patient management | Derived theme | Focus groups | Not stated Constant comparative analysis |
Vermunt (2018) [54] Netherlands | 15 GPs Mean age: 51 years. Mean time in practice: 16 years. Gender: 6 males; 9 females. | Older patients with multimorbidity in general practice Patient management | Focus | Semi-structured interviews | Not stated Thematic analysis |