["All of us actually practice EBM!" - Attitudes of German GPs towards evidence-based medicine and clinical guidelines in daily practice: a focus group study].
BACKGROUND
Implementation of guidelines in general practice is difficult. Do general practitioners (GPs) reject evidence-based medicine (EBM) in general? Which attitudes do GPs have towards EBM and guidelines, and which value do they attach to EBM in daily routine?


METHODS
We conducted a qualitative study using five focus groups with 53 GPs. The study was set in the German federal states of Bavaria, Saxony, North Rhine-Westphalia, Hesse and Hamburg. Participants were selected according to area (rural/urban), region (North/South, East/West) and grade of professionalisation. Focus groups were digitally recorded and fully transcribed. Data were analysed in a multidisciplinary team using qualitative content analysis.


RESULTS
Most participants felt positive towards EBM. Lack of feasibility was explicitly mentioned: the participants distinguished between "practised" and "true" EBM. Guidelines are often considered unsuitable for general practice. The GPs felt confident that their treatment of patients was evidence-based.


CONCLUSIONS
Compared to older studies, German GPs have an increasingly favourable opinion about EBM. In order to enhance the practical application of EBM and guidelines the attitudes of GPs need to be considered.
Institut für Allgemeinmedizin und Familienmedizin, Fakultät für Gesundheit, Universität Witten/Herdecke, Witten; Institut für Allgemeinmedizin (ifam), Medizinische Fakultät, Heinrich Heine-Universität, Düsseldorf. Electronic address: bettina.buecker@uni-wh.de.
Bettina
B
Bücker
Marcus
M
Redaèlli
Dusan
D
Simic
Stefan
S
Wilm
D001291:Attitude of Health Personnel; D019317:Evidence-Based Medicine / Q000592:standards* / Q000706:statistics & numerical data*; D005194:Family Practice / Q000592:standards* / Q000706:statistics & numerical data*; D017144:Focus Groups; D005858:Germany; D019983:Guideline Adherence / Q000592:standards* / Q000706:statistics & numerical data*; D006801:Humans; D009313:National Health Programs / Q000592:standards* / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D036301:Qualitative Research; D011785:Quality Assurance, Health Care / Q000592:standards / Q000706:statistics & numerical data
Allgemeinmedizin; Evidenzbasierte Medizin; Fokusgruppen; General practice; Haltungen; Leitlinien; attitude; evidence-based medicine (EBM); focus groups; guideline