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Published on: November 10, 2017
GPs' decisions on drug treatment for patients with high cholesterol values: a think-aloud study
Lars Backlund1, Ylva Skånér, Henry Montgomery
1Center for Family Medicine, Karolinska Institutet, Alfred Nobels allé 12, SE-141 83 Huddinge, Sweden. lars.backlund@klinvet.ki.se
Background:
The purpose was to examine how General Practitioners (GPs) use clinical information and rules from guidelines in their decisions on drug treatment for high cholesterol values.
Methods:
Twenty GPs were presented with six case vignettes and were instructed to think aloud while successively more information about a case was presented, and finally to decide if a drug should be prescribed or not. The statements were coded for the clinical information to which they referred and for favouring or not favouring prescription.
Results:
The evaluation of clinical information was compatible with decision-making as a search for reasons or arguments. Lifestyle-related information like smoking and overweight seemed to be evaluated from different perspectives. A patient's smoking favoured treatment for some GPs and disfavoured treatment for others.
Conclusions:
The method promised to be useful for understanding why doctors differ in their decisions on the same patient descriptions and why rules from the guidelines are not followed strictly.
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