1. How do general practitioners put preventive care recommendations into practice? A cross-sectional study in Switzerland and France
- Author
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Jean-Pascal Fournier, Paul Sebo, Dagmar M. Haller, Bernard Cerutti, Hubert Maisonneuve, Fabien Rougerie, Nicolas Senn, Cédric Rat, Primary Care Unit [Geneva, Switzerland] (Faculty of Medicine), Université de Genève = University of Geneva (UNIGE), Département de médecine générale [Université de Nantes - UFR de Médecine et des Techniques Médicales] (DMG Nantes), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes), Université de Strasbourg (UNISTRA), Université de Lausanne = University of Lausanne (UNIL), Geneva University Hospitals and Geneva University, Département de Médecine Générale [UNIV Strasbourg] (Faculté de Médecine), and NantesU ST, Dépôt
- Subjects
Male ,Pediatrics ,Cross-sectional study ,[SDV]Life Sciences [q-bio] ,General Practice ,Colonoscopy ,030204 cardiovascular system & hematology ,0302 clinical medicine ,prevention ,Surveys and Questionnaires ,030212 general & internal medicine ,Practice Patterns, Physicians' ,Aged, 80 and over ,Response rate (survey) ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,medicine.diagnostic_test ,General Medicine ,Middle Aged ,[SDV] Life Sciences [q-bio] ,Primary Prevention ,Prostate cancer screening ,Female ,France ,Guideline Adherence ,General practice / Family practice ,Colorectal Neoplasms ,Alcohol-Related Disorders ,Switzerland ,Adult ,medicine.medical_specialty ,Attitude of Health Personnel ,Binge drinking ,Guidelines as Topic ,diversity ,primary care ,03 medical and health sciences ,General Practitioners ,ddc:610/370 ,medicine ,Humans ,MESH: Adult Aged Aged, 80 and over Alcohol-Related Disorders / prevention & control Attitude of Health Personnel Colorectal Neoplasms / prevention & control Cross-Sectional Studies Dyslipidemias / prevention & control Female France General Practice* General Practitioners* Guideline Adherence* Guidelines as Topic Humans Male Middle Aged Practice Patterns, Physicians'* Preventive Medicine / methods* Primary Prevention / methods* Prostatic Neoplasms / prevention & control Surveys and Questionnaires Switzerland ,Aged ,Dyslipidemias ,ddc:613 ,Preventive healthcare ,business.industry ,screening ,Research ,Prostatic Neoplasms ,Guideline ,Cross-Sectional Studies ,Alcohol-Related Disorders/prevention & control ,Colorectal Neoplasms/prevention & control ,Dyslipidemias/prevention & control ,Preventive Medicine/methods ,Primary Prevention/methods ,Prostatic Neoplasms/prevention & control ,Family medicine ,Preventive Medicine ,Brief intervention ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
ObjectivesWe previously identified that general practitioners (GPs) in French-speaking regions of Europe had a variable uptake of common preventive recommendations. In this study, we describe GPs’ reports of how they put different preventive recommendations into practice.Design, setting and participantsCross-sectional study conducted in 2015 in Switzerland and France. 3400 randomly selected GPs were asked to complete a postal (n=1100) or online (n=2300) questionnaire. GPs who exclusively practiced complementary and alternative medicine were not eligible for the study. 764 GPs (response rate: postal 47%, online 11%) returned the questionnaire (428 in Switzerland and 336 in France).Main outcome measuresWe investigated how the GPs performed five preventive practices (screening for dyslipidaemia, colorectal and prostate cancer, identification of hazardous alcohol consumption and brief intervention), examining which age group they selected, the screening frequency, the test they used, whether they favoured shared decision for prostate cancer screening and their definition of hazardous alcohol use.ResultsA large variability was observed in the way in which GPs provide these practices. 41% reported screening yearly for cholesterol, starting and stopping at variable ages. 82% did not use any test to identify hazardous drinking. The most common responses for defining hazardous drinking were, for men, ≥21 drinks/week (24%) and ≥4 drinks/occasion for binge drinking (20%), and for women, ≥14 drinks/week (28%) and ≥3 drinks/occasion (21%). Screening for colorectal cancer, mainly with colonoscopy in Switzerland (86%) and stool-based tests in France (93%), was provided every 10 years in Switzerland (65%) and 2 years in France (91%) to patients between 50 years (87%) and 75 years (67%). Prostate cancer screening, usually with shared decision (82%), was provided yearly (62%) to patients between 50 years (74%) and 75–80 years (32%–34%).ConclusionsThe large diversity in the way these practices are provided needs to be addressed, as it could be related to some misunderstandingof the current guidelines, to barriers for guideline uptake or, more likely, to the absence of agreement between the various recommendations.
- Published
- 2017
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