Opiniones de médicos de atención primaria, psiquiatras y psicólogos acerca de las guías de práctica clínica para la depresión. Un estudio cualitativo exploratorio

Abstract

Aim To explore the views on clinical practice guidelines (CPG) of general practitioners (GP), psychiatrists, and psychologists. Design Descriptive-exploratory qualitative study based on semi-structured individual and group interviews. Setting Public primary health care and mental health centres in Barcelona, Sabadell, Cornellà de Llobregat and Gavà. Participants and context A total of 31 health professionals (10 GPs, 11 psychiatrists, and 10 psychologists) interviewed at their work place or at the research unit between October 2007 and June 2008. Method Convenience sample. Participants were heterogeneous as regards sex, age, experience and workplace. Interviews were recoded and transcribed. Content analysis. Triangulation between techniques and results comparisons with participants was carried out as quality control. Results The main advantages of CPGs were that they helped in decision making and gave security. On the other hand, participants were sceptical about the objectivity of GPC and considered that recommendations could not be applied to their individual patients. Additionally, they perceived CPG as inflexible. At the time of the study, GPs did not know of any CPG for depression. Specialists knew several CPGs but they did not use them as they prioritise their own experience. Conclusions There are some erroneous ideas about what a CPG is. If we want to implement CPGs, it is important to carry out some previous work presenting what a CPG is, what it is not and when it could be useful.