ABSTRACT
OBJECTIVES: To determine the information needs of primary care physicians by identifying the frequency and type of questions arising during consultation, and by describing the information-search pattern. DESIGN. Observational, descriptive, multi-centre study. SETTING: Primary care practices in Madrid, Spain. PARTICIPANTS: Random sample, proportionally stratified by area (urban/rural) and specialty (general practitioner/paediatrician), of 208 primary care physicians out of a total of 1182 physicians; 112 agreed to take part. INTERVENTIONS: Physicians consultations were video-recorded for four hours. Between patients, they were asked to pose all the clinical questions arising during the patient visit and the sources of information used to answer them. Unresolved questions were followed up by phone 2 weeks later to check if answers had been found and what sources of information had been used. Clinical questions were classified by topic and type. MAIN MEASUREMENTS: Number of questions posed and their answers; topic and type of information; information resources used. RESULTS: A total of 3511 patient consultations, leading to 635 clinical questions, were recorded. The most frequent questions were on pharmacology (10%) for general practitioners, and infectious disease (19%) for paediatricians. The most frequent type of question was on the cause/interpretation of a clinical finding (44% for general practitioners and 48% for paediatricians). Answers to 39% of the questions were not sought. A 86% of the answers sought were solved, mainly using the drug compendium (35%) or a text-book (18%). CONCLUSIONS: Primary care physicians tried to resolve less than two-thirds of the questions asked, and mainly did so through readily available printed material. Better methods are needed to provide answers to questions that arise in clinical practice.
Subject(s)
Information Seeking Behavior , Primary Health Care , Adult , Female , Humans , MaleABSTRACT
Objetivo. Determinar las necesidades de información de los médicos de atención primaria mediante la descripción de la frecuencia y tipo de preguntas clínicas, así como el patrón de búsqueda. Diseño. Estudio observacional, descriptivo, multicéntrico. Emplazamiento. Consultas de atención primaria. Áreas de Salud 1, 3, 8, 9 y 10 de Madrid. Participantes. Muestra aleatoria estratificada por zona (urbana/rural) y especialidad (médico de familia/pediatra) de 208 médicos de atención primaria de una población de 1.182, de los que finalmente aceptaron participar 112. Intervenciones. Se grabó mediante cámara de vídeo a los médicos durante 4 h de consulta. Especificaron entre paciente y paciente las preguntas que les surgían y las fuentes de información utilizadas para resolverlas. Las preguntas sin resolver fueron seguidas mediante contacto telefónico 2 semanas después para valorar si se habían obtenido respuestas y las fuentes utilizadas. Las preguntas se clasificaron por tema y tipo. Mediciones principales. Número de preguntas clínicas y respuestas; tema y tipo de información; recursos de información utilizados. Resultados. Se grabó a 3.511 pacientes que generaron 635 preguntas. El tema más frecuente fue la farmacología (10%) entre los médicos de familia y las enfermedades infecciosas (19%) entre los pediatras. El tipo más frecuente fue la causa/interpretación de un hallazgo clínico (el 44% en medicina de familia y el 48% en pediatría). El 39% de las dudas no se buscaron. De las buscadas, se resolvió el 86%, a través del vademécum (35%) y libros de texto (18%). Conclusiones. De las preguntas generadas, menos de dos tercios se intentaron resolver, sobre todo mediante material impreso de fácil acceso. Se necesitan métodos capaces de dar respuesta a las necesidades de información que surgen en la consulta de atención primaria
Objectives. To determine the information needs of primary care physicians by identifying the frequency and type of questions arising during consultation, and by describing the information-search pattern. Design. Observational, descriptive, multi-centre study. Setting. Primary care practices in Madrid, Spain. Participants. Random sample, proportionally stratified by area (urban/rural) and specialty (general practitioner/paediatrician), of 208 primary care physicians out of a total of 1182 physicians; 112 agreed to take part. Interventions. Physicians consultations were video-recorded for four hours. Between patients, they were asked to pose all the clinical questions arising during the patient visit and the sources of information used to answer them. Unresolved questions were followed up by phone 2 weeks later to check if answers had been found and what sources of information had been used. Clinical questions were classified by topic and type. Main measurements. Number of questions posed and their answers; topic and type of information; information resources used. Results. A total of 3511 patient consultations, leading to 635 clinical questions, were recorded. The most frequent questions were on pharmacology (10%) for general practitioners, and infectious disease (19%) for paediatricians. The most frequent type of question was on the cause/interpretation of a clinical finding (44% for general practitioners and 48% for paediatricians). Answers to 39% of the questions were not sought. A 86% of the answers sought were solved, mainly using the drug compendium (35%) or a text-book (18%). Conclusions. Primary care physicians tried to resolve less than two-thirds of the questions asked, and mainly did so through readily available printed material. Better methods are needed to provide answers to questions that arise in clinical practice
