title: Management of patients with sore throats in relation to guidelines: an interview study in Sweden.
abstract: OBJECTIVE
  To explore how a group of Swedish general practitioners (GPs) manage patients with a sore throat in relation to current guidelines as expressed in interviews.
  
  
  METHODS
  Qualitative content analysis was used to analyse semi-structured interviews.
  
  
  METHODS
  Swedish primary care.
  
  
  METHODS
  A strategic sample of 25 GPs.
  
  
  METHODS
  Perceived management of sore throat patients.
  
  
  RESULTS
  It was found that nine of the interviewed GPs were adherent to current guidelines for sore throat and 16 were non-adherent. The two groups differed in terms of guideline knowledge, which was shared within the team for adherent GPs while idiosyncratic knowledge dominated for the non-adherent GPs. Adherent GPs had no or low concerns for bacterial infections and differential diagnosis whilst non-adherent GPs believed that in patients with a sore throat any bacterial infection should be identified and treated with antibiotics. Patient history and examination was mainly targeted by adherent GPs whilst for non-adherent GPs it was often redundant. Non-adherent GPs reported problems getting patients to abstain from antibiotics, whilst no such problems were reported in adherent GPs.
  
  
  CONCLUSIONS
  This interview study of sore throat management in a strategically sampled group of Swedish GPs showed that while two-thirds were non-adherent and had a liberal attitude to antibiotics one-third were guideline adherent with a restricted view on antibiotics. Non-adherent GPs revealed significant knowledge gaps. Adherent GPs had discussed guidelines within the primary care team while non-adherent GPs had not. Guideline implementation thus seemed to be promoted by knowledge shared in team discussions.
authors.affiliation: Department of Clinical Sciences, Malmö, Family Medicine, Lund University , Sweden.
authors.forename: Katarina
authors.initials: K
authors.lastname: Hedin
authors.forename: Eva Lena
authors.initials: EL
authors.lastname: Strandberg
authors.forename: Hedvig
authors.initials: H
authors.lastname: Gröndal
authors.forename: Annika
authors.initials: A
authors.lastname: Brorsson
authors.forename: Hans
authors.initials: H
authors.lastname: Thulesius
authors.forename: Malin
authors.initials: M
authors.lastname: André
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019468:Disease Management; D011307:Drug Prescriptions; D005194:Family Practice / Q000379:methods; D005260:Female; D019983:Guideline Adherence / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010612:Pharyngitis / Q000188:drug therapy*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D036301:Qualitative Research; D013548:Sweden / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: General practice; Sweden; general practitioners; guidelines; qualitative research; sore throat