Family physicians and dementia in Canada: Part 1. Clinical practice guidelines: awareness, attitudes, and opinions.
OBJECTIVE
To assess Canadian family physicians' awareness of, attitudes toward, and use of the 1999 Canadian Consensus Conference on Dementia (CCCD) clinical practice guidelines (CPGs); to explore the barriers and enablers to implementing dementia CPGs in clinical practice; and to identify more effective strategies for future dementia guideline development and dissemination.


METHODS
Qualitative study using focus groups.


METHODS
Academic family practice clinics in Calgary, Alta, Ottawa, Ont, and Toronto, Ont.


METHODS
Eighteen family physicians.


METHODS
Using a semistructured interview guide, we conducted 4 qualitative focus groups of 4 to 6 family physicians whose practices we had audited in a previous study. Transcripts were coded using an inductive data analytic strategy, and categories and themes were identified and described using the principles of thematic analysis.


RESULTS
Four major themes emerged from the focus group discussions. Family physicians 1) were minimally aware of the existence and the detailed contents of the CCCD guidelines; 2) had strong views about the purposes of guidelines in general; 3) expressed strong concerns about the role of the pharmaceutical industry in the development of such guidelines; and 4) had many ideas to improve future dementia guidelines and CPGs in general.


CONCLUSIONS
Family physicians were minimally aware of the 1999 CCCD CPGs. They acknowledged, however, the potential of future CPGs to assist them in patient care and offered many strategies to improve the development and dissemination of future dementia guidelines. Future guidelines should more accurately reflect the day-to-day practice experiences and challenges of family physicians, and guideline developers should also be cognizant of family physicians' perceptions that pharmaceutical companies' funding of CPGs undermines the objectivity and credibility of those guidelines.
Pimlott
Nicholas J G
NJ
Women's College Hospital, 60 Grosvenor St, Toronto, ON M5S 1B6, Canada. nick.pimlott@utoronto.ca
Persaud
Malini
M
Drummond
Neil
N
Cohen
Carole A
CA
Silvius
James L
JL
Seigel
Karen
K
Hollingworth
Gary R
GR
Dalziel
William B
WB
D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001364:Awareness; D003704:Dementia / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D009864:Ontario; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards*; D011787:Quality of Health Care