Underlying motivations hampering Flemish primary care physicians from overcoming the barriers in osteoporosis care: an EMR-facilitated clinical reasoning study
Abstract Background Over half of the European population aged minimum 65 years presents with at least two chronic diseases. Attention towards these diseases exhibits disparities, with limited primary care physician (PCP) attention for osteoporosis. This was confirmed in a previous integrated osteopo...
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-023-10441-7 |
| _version_ | 1797388400552050688 |
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| author | Caroline Verdonck Ellis Van Daele Ruben Willems Liesbeth Borgermans Pauline Boeckxstaens |
| author_facet | Caroline Verdonck Ellis Van Daele Ruben Willems Liesbeth Borgermans Pauline Boeckxstaens |
| author_sort | Caroline Verdonck |
| collection | DOAJ |
| description | Abstract Background Over half of the European population aged minimum 65 years presents with at least two chronic diseases. Attention towards these diseases exhibits disparities, with limited primary care physician (PCP) attention for osteoporosis. This was confirmed in a previous integrated osteoporosis care (IOC) project in which notable difficulties to enlist PCPs arose. Consequently, this study was initiated in Flemish PCPs for in-depth analysis of underlying mechanisms hampering PCPs to fully commit to osteoporosis care. Methods A qualitative Electronic Medical Record (EMR)-facilitated clinical reasoning study was conducted. A semi-structured interview guide was employed to guide PCPs from reflections on their own patients to broader views regarding osteoporosis care. An inductive thematic analysis was performed using NVivo 12. Results Thirteen PCPs were interviewed. They stated that osteoporosis patients often had complex (medical) profiles. PCPs emphasised the ongoing necessity for prioritisation within this context. This leads to a competition for PCP attention during consultations at three levels: i. between acute versus preventive care; ii. between primary fracture prevention and other preventive services and iii. between secondary fracture prevention and other preventive services; spanning eight areas of competition: disease significance, perceived impact, PCP awareness, the patient agenda, PCP competence, PCP support, perceived patient burden, and efficiency of care provision. Applicability of these areas of competition differed between levels. Conclusion The intricate context in which PCPs operate, creates a competition for PCP attention leading to a lack of attention for fracture prevention. To preserve efforts in fracture prevention, areas of competition should be systematically addressed. Trial registration Approval for the study has been provided by the Ghent University Hospital Ethics Committee (BC-09797). |
| first_indexed | 2024-03-08T22:40:17Z |
| format | Article |
| id | doaj.art-4b61a9fed7d643c298b006d936cfb238 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-03-08T22:40:17Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-4b61a9fed7d643c298b006d936cfb2382023-12-17T12:11:09ZengBMCBMC Health Services Research1472-69632023-12-012311910.1186/s12913-023-10441-7Underlying motivations hampering Flemish primary care physicians from overcoming the barriers in osteoporosis care: an EMR-facilitated clinical reasoning studyCaroline Verdonck0Ellis Van Daele1Ruben Willems2Liesbeth Borgermans3Pauline Boeckxstaens4Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent UniversityDepartment of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent UniversityDepartment of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent UniversityDepartment of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent UniversityDepartment of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent UniversityAbstract Background Over half of the European population aged minimum 65 years presents with at least two chronic diseases. Attention towards these diseases exhibits disparities, with limited primary care physician (PCP) attention for osteoporosis. This was confirmed in a previous integrated osteoporosis care (IOC) project in which notable difficulties to enlist PCPs arose. Consequently, this study was initiated in Flemish PCPs for in-depth analysis of underlying mechanisms hampering PCPs to fully commit to osteoporosis care. Methods A qualitative Electronic Medical Record (EMR)-facilitated clinical reasoning study was conducted. A semi-structured interview guide was employed to guide PCPs from reflections on their own patients to broader views regarding osteoporosis care. An inductive thematic analysis was performed using NVivo 12. Results Thirteen PCPs were interviewed. They stated that osteoporosis patients often had complex (medical) profiles. PCPs emphasised the ongoing necessity for prioritisation within this context. This leads to a competition for PCP attention during consultations at three levels: i. between acute versus preventive care; ii. between primary fracture prevention and other preventive services and iii. between secondary fracture prevention and other preventive services; spanning eight areas of competition: disease significance, perceived impact, PCP awareness, the patient agenda, PCP competence, PCP support, perceived patient burden, and efficiency of care provision. Applicability of these areas of competition differed between levels. Conclusion The intricate context in which PCPs operate, creates a competition for PCP attention leading to a lack of attention for fracture prevention. To preserve efforts in fracture prevention, areas of competition should be systematically addressed. Trial registration Approval for the study has been provided by the Ghent University Hospital Ethics Committee (BC-09797).https://doi.org/10.1186/s12913-023-10441-7MultimorbidityPrimary carePrimary care physiciansHealth prioritiesClinical decisionMaking |
| spellingShingle | Caroline Verdonck Ellis Van Daele Ruben Willems Liesbeth Borgermans Pauline Boeckxstaens Underlying motivations hampering Flemish primary care physicians from overcoming the barriers in osteoporosis care: an EMR-facilitated clinical reasoning study BMC Health Services Research Multimorbidity Primary care Primary care physicians Health priorities Clinical decision Making |
| title | Underlying motivations hampering Flemish primary care physicians from overcoming the barriers in osteoporosis care: an EMR-facilitated clinical reasoning study |
| title_full | Underlying motivations hampering Flemish primary care physicians from overcoming the barriers in osteoporosis care: an EMR-facilitated clinical reasoning study |
| title_fullStr | Underlying motivations hampering Flemish primary care physicians from overcoming the barriers in osteoporosis care: an EMR-facilitated clinical reasoning study |
| title_full_unstemmed | Underlying motivations hampering Flemish primary care physicians from overcoming the barriers in osteoporosis care: an EMR-facilitated clinical reasoning study |
| title_short | Underlying motivations hampering Flemish primary care physicians from overcoming the barriers in osteoporosis care: an EMR-facilitated clinical reasoning study |
| title_sort | underlying motivations hampering flemish primary care physicians from overcoming the barriers in osteoporosis care an emr facilitated clinical reasoning study |
| topic | Multimorbidity Primary care Primary care physicians Health priorities Clinical decision Making |
| url | https://doi.org/10.1186/s12913-023-10441-7 |
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