Related Experiment Videos
Problems with implementing guidelines: a randomised controlled trial of consensus management of dyspepsia
R H Jones1, S Lydeard, J Dunleavey
1Department of Primary Medical Care, University of Southampton.
Quality in Health Care : QHC
|November 4, 1993
Summary
Developing consensus guidelines for dyspepsia management between general practitioners (GPs) and specialists was feasible. However, their impact on prescribing and investigations was limited, showing variable adoption and no clear cost benefits.
Area of Science:
- Gastroenterology
- Health Services Research
- Clinical Practice Guidelines
Background:
- Dyspepsia management presents challenges for general practitioners (GPs) and specialists.
- Developing consensus guidelines aims to standardize care and improve outcomes.
Purpose of the Study:
- To assess the feasibility of creating consensus guidelines for dyspepsia management.
- To evaluate the impact of these guidelines on GPs' prescribing habits, investigation use, and referral rates.
Main Methods:
- A randomized controlled trial was conducted in the Southampton and South West Hampshire Health District.
- 179 GPs participated, with 78 in the study group and 107 in the control group.
- Prescribing costs, referral rates, and investigation use for dyspepsia were compared before and after guideline implementation.
Main Results:
- Guidelines were developed successfully, but their adoption was inconsistent.
- Referral rates for upper gastrointestinal symptoms decreased in both groups.
- No significant changes were observed in the use of endoscopy or radiology; prescribing costs increased in the study group due to ulcer-healing agents.
Conclusions:
- Consensus guideline development for dyspepsia is feasible.
- Guideline impact on clinical behavior and cost-effectiveness was limited and variable.
- Further strategies may be needed to ensure effective adoption and improve care quality.