Research article

'Experience talks': physician prioritisation of contrasting interventions to optimise management of acute cough in general practice

Jochen WL Cals¹ , Christopher C Butler² and Geert-Jan Dinant¹

¹  Department of General Practice, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, The Netherlands

²  Department of primary care and public health, School of Medicine, Cardiff University, Cardiff, UK

author email corresponding author email

Implementation Science 2009, 4:57doi:10.1186/1748-5908-4-57

Published:	8 September 2009

Abstract

Background

Uptake of interventions to improve quality of care by clinicians is variable and is influenced by clinicians' attitudes. The influence of clinicians' experience with an intervention on their preference for adopting interventions is largely unknown.

Methods

Thematic analysis of semi-structured interviews exploring views and attitudes towards an illness-focused intervention (specific communication skills training) and a disease-focused intervention (C-reactive protein, or CRP, point-of-care testing) to optimize management of lower respiratory tract infections (LRTI) among general practitioners (GPs) who had used both interventions for two years in a randomised trial (exposed GPs), and GPs without experience of either intervention (non-exposed GPs).

Results

All but two of the ten non-exposed GPs indicated that they would prioritise implementation of the disease-focused intervention of CRP testing over communication skills training, while all but one GP in the exposed group said that they would prioritise the illness-focused approach of communication skills training as it was more widely applicable, whereas CRP testing was confirmatory and useful in a subgroups of patients.

Conclusion

There are differences in attitudes to prioritising contrasting interventions for optimising LRTI management among GPs with and without experience of using the interventions, although GPs in both groups recognised the importance of both approaches to optimise management of acute cough. GPs' experiences with and attitudes towards interventions need to be taken into account when planning rollout of interventions aimed at changing clinical practice.