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General practice / Family practice
Research
The influence of time pressure on adherence to guidelines in primary care: an experimental study
  1. Evangelia Tsiga1,
  2. Efharis Panagopoulou1,
  3. Nick Sevdalis2,
  4. Anthony Montgomery3,
  5. Alexios Benos1
  1. 1School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
  2. 2Department of Surgery and Cancer, Imperial College, London, UK
  3. 3Department of Educational and Social Policy, University of Macedonia, Social Sciences, Thessaloniki, Greece
  1. Correspondence to Dr Tsiga Evangelia evelyntsiga{at}gmail.com

Abstract

Objectives Evidence from cognitive sciences has systematically shown that time pressure influences decision-making processes. However, very few studies have examined the role of time pressure on adherence to guidelines in clinical practice. The aim of this study was to examine the influence of time pressure on adherence to guidelines in primary care concerning: history taking, clinical examination and advice giving.

Design A within-subjects experimental design was used.

Setting Academic.

Participants 34 general practitioners (GPs) were assigned to two experimental conditions (time pressure vs no time pressure) consecutively, and presented with two scenarios involving virus respiratory tract infections.

Primary and secondary outcome measures Outcome measures included adherence to guidelines on history taking, clinical examination and advice giving.

Results Under time pressure, GPs asked significantly less questions concerning presenting symptoms, than the ones indicated by the guidelines, (p=0.019), conducted a less-thorough clinical examination (p=0.028), while they gave less advice on lifestyle (p=0.05).

Conclusions As time pressure increases as a result of high workload, there is a need to examine how adherence to guidelines is affected to safeguard patient's safety.

  • PRIMARY CARE
  • GENERAL MEDICINE (see Internal Medicine)

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/3.0/ and http://creativecommons.org/licenses/by-nc/3.0/legalcode

https://doi.org/10.1136/bmjopen-2013-002700

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