| 1. |
- Moen, Janne, 1980-, et al.
(författare)
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GPs' perceptions of multiple-medicine use in older patients
- 2010
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Ingår i: Journal of Evaluation In Clinical Practice. - : Wiley. - 1356-1294 .- 1365-2753. ; 16:1, s. 69-75
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Tidskriftsartikel (refereegranskat)abstract
- Rationale, aim and objective: Multiple-medicine use (polypharmacy) is a growing problem for older patients, prescribers and health policy makers. The general practitioner (GP) is most often the main professional care provider; hence, improvements of treatment can only be carried out in concordance with GPs. The aim of this study was, therefore, to explore using a qualitative approach GPs' perspectives of treating older users of multiple medicines. Method: Six focus groups, with four private GPs and 27 county-employed GPs, were analysed by using the framework method. Results: In contrast to definitions in most epidemiologic studies, the GPs gave a spontaneous definition of polypharmacy as 'the administration of more medicines than are clinically indicated'. They had problems stating both a cut-off number and which medicines should be included. Clinical practice guidelines were thought of as 'medicine generators', having an ambiguous effect on the GPs, who both trust them and find them difficult to apply. There was a perceived lack of communication between GPs and hospital specialists concerning their patients' medicines, which was further perceived to reduce treatment quality. The influence of patient pressure was acknowledged by the GPs as a factor contributing to the development of multiple-medicine use. Conclusions: The GPs felt insecure although surrounded by clinical practice guidelines. There is a need for policy makers to appreciate this paradox, as the problem is likely to grow in size and proportion. GPs must be empowered to handle the increasing proportion of older users of multiple medicines with individual agendas, receiving care from multiple specialists.
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| 2. |
- Moen, Janne, 1980-, et al.
(författare)
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Interaction Between Participants in Focus Groups With Older Patients and General Practitioners
- 2010
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Ingår i: Qualitative Health Research. - : SAGE Publications. - 1049-7323 .- 1552-7557. ; 20:5, s. 607-616
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Tidskriftsartikel (refereegranskat)abstract
- Group interaction is put forward as the principal advantage for focus group research although rarely reported on. The aim of this paper is to contribute to the methodological knowledge regarding focus group research by providing an empirical example of the application of the Lehoux, Poland and Daudelin template suggested for analysis of the interaction in focus groups. The data source was 18 focus groups' performance in Sweden; 12 with older participants and 6 with general practitioners (GPs). GPs found a common ground in belonging to the same profession, while older participants instead of constituting a group in the words real sense started just sharing a common focus. We found the template easy to understand and use, except for identifying participants' explicit and implicit purposes for participating. Further, adding an interaction analysis to the content analysis helped us appreciate and clarify the contexts from which these data were created.
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