Factors influencing adherence to guidelines in general practice.
OBJECTIVE
To identify and assess the effects of general practitioner and patient characteristics on global adherence to pharmacotherapeutic guidelines.


METHODS
In a cross-sectional study in the northern Netherlands, a two-level multilevel model was applied to patients (n = 269,067) in 190 practices with a total of 251 general practitioners. The dependent variable was the global adherence to pharmacotherapeutic guidelines as a measure of good prescribing in a general practice setting.


RESULTS
The mean global adherence was 82%. Two general practice variables, organization form and degree of urbanization influenced the global adherence, whereas all patient variables (age and gender) and the patient-related prescription characteristics (costs, volume, different ATC-codes) were significant predictors for the global adherence. The total explained variance was 28%.


CONCLUSIONS
Patient characteristics have a greater influence on prescribing behavior than general practitioner characteristics.
Stewart
Roy E
RE
University of Groningen, Department of Health Sciences, Northern Centre for Health Care Research, The Netherlands. r.e.stewart@med.rug.nl
Vroegop
Sebastiaan
S
Kamps
Gerard B
GB
van der Werf
Ger Th
GT
Meyboom-de Jong
Betty
B
D000328:Adult; D003430:Cross-Sectional Studies; D003659:Decision Making, Organizational; D011307:Drug Prescriptions; D004363:Drug Utilization / Q000592:standards*; D005194:Family Practice / Q000592:standards*; D005260:Female; D019983:Guideline Adherence; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009426:Netherlands; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards*