Preferences Of Practitioners Research Articles

Utilization of antihypertensive drugs in obesity-related hypertension: A retrospective observational study in a cohort of patients from Southern Italy

Although the pathophysiological mechanisms of arterial hypertension are different in obese and lean patients, hypertension guidelines do not include specific recommendations for obesity-related hypertension and, therefore, there is a considerable uncertainty on which antihypertensive drugs should be used in this condition. Moreover, studies performed in general population suggested that some antihypertensive drugs may increase body weight, glycemia and LDL-cholesterol but it is unclear how this impact on drug choice in clinical practice in the treatment of obese hypertensive patients. Therefore, in order to identify current preferences of practitioners for obesity-related hypertension, in the present work we evaluated antihypertensive drug therapy in a cohort of 129 pharmacologically treated obese hypertensive patients (46 males and 83 females, aged 51.95 ± 10.1 years) that came to our observation for a nutritional consultation. Study design was retrospective observational. Differences in the prevalence of use of the different antihypertensive drug classes among groups were evaluated with χ2square analysis. Threshold for statistical significance was set at p

General practitioners’ preferences with regard to colorectal cancer screening organisation Colon cancer screening medico-legal aspects

ObjectiveFrench health authorities put general practitioners at the heart of the colorectal cancer screening. This position raises organisational issues and poses medico-legal problems for the professionals and institutions involved in these campaigns, related to the key concepts of medical decisions and suitability of standards. The objective of our study is to reveal the preferences of general practitioners related to colorectal cancer screening organisation with regard to the medico-legal risk MethodsA discrete choice questionnaire presenting hypothetical screening scenarios was mailed to 2114 physicians from 20 French different areas. The preferences of 358 general practitioners were analysed using logistic regression models. ResultsThe factors that have significant impact on the preferences of general practitioners are the capacity of the primary care professional in the procedure, the manner in which pre-screening information is given to patients, the manner in which screening results are given to patients, the number of reminders sent to patients who test positive and who do not undergo a colonoscopy and the remuneration of the attending physician. ConclusionsOur results reveals that current colorectal cancer screening organisation is not adapted to general practitioners preferences. This work offers the public authorities avenues for reflection on possible developments in order to optimize the involvement of general practitioners in the promotion of cancer screening programme.

Email communication in project management: A bane or a blessing?

Background: Project success used to be measured solely in terms of efficiency metrics such as scope, cost and time; however, there are proposals that more attention should be paid to process-related performance factors such as communication. The advent of email has significantly impacted the way the world communicates.Objectives: This study investigates the preference of email communication relative to other communication mediums in project environments and the effect of email communication on feelings of stress and overload in the workplace.Method: A survey with 430 responses was conducted to determine the communication preferences of project practitioners in a typical project. The average rank and frequency response methods were used to analyse the data.Results: The findings indicate that the communication preferences of project practitioners still support the media richness theory and that face-to-face communication is the preferred communication medium in most situations. Despite email being disruptive and a cause of stress, the respondents did not indicate being overloaded because of email.Conclusion: Even though there has been a dramatic shift towards email and electronic communication in projects, face-to-face communication is still the most preferred communication type for most situations. Furthermore, email is perceived as an effective tool to delegate, can be used to build and develop relationships and trust, and is an efficient and effective tool that contributes to project communication success.

Preference and usage of intracanal medications during endodontic treatment.

Objectives:To investigate the preferences of general dental practitioners (GDPs) and endodontists in using endodontic intra-canal medications (ICMs).Methods:This observational and descriptive study was conducted in 2014 in the western province of Saudi Arabia. Following ethical clearance and 2 pilot studies, a web-based questionnaire was electronically sent to 375 randomly and systematically selected GDPs and all endodontists in the western province (n=49). An accompanying e-mail explained the study’s aims and confirmed that the data yielded would remain confidential. The responses were collected, and the data was analyzed using the Chi-square test at p=0.05.Results:Significantly, the highest proportion of respondents (53.7%) reported disinfection of the root canals as the main function of ICMs. Calcium hydroxide (CH) was the preferred material of the majority of those who used the same ICM in all cases (85.7%). While the vast majority of all endodontists (87.5%) used CH after pulp extirpation, 48.5% of GDPs used formocresol (p<0.001). Almost 30% of those who used ICMs after pulp extirpation did not do so after cleaning and shaping of vital cases. Most endodontists used CH (62.5%) and antibiotics (37.5%) in necrotic pulp cases without apical lesions, which were significantly greater than those of GDPs who did the same (43.8% and 17.2%).Conclusions:Participants were aware that the main function of ICMs is disinfection of the root canal system. However, it is clear that GDPs should reduce their reliance on phenol- and formaldehyde-based medications. There was a distinct trend toward the use of ICMs, especially CH, in necrotic pulp cases.

Position-in-frame

An integral connection point between the screenplay and reader/viewer is the protagonist’s transformative journey. The construction of this narrative backbone is critical to the articulation of overarching thematic concerns and story premise but also reflects the story creator’s worldview- one often coloured by representations of gender. The Hollywood model certainly divides narrative function along gender lines but does this representation hold true within a different cultural context? This article examines the selected screen stories of Danish director Susanne Bier whose partnership with screenwriter Anders Thomas Jensen is one of Denmark’s most successful film partnerships. Employing a case study methodology I examine the dramatic function of and agency afforded screen characters and the critical dynamic between cultural landscape, practitioner preference and narrative inquiry. Key to this address is an exploration of mobility, legacy and sacrifice as textual considerations of gender and its utilisation as transnational narrative strategy.

Tendencias en el manejo de la litiasis urinaria en América Latina, España y Portugal: resultados de una encuesta en la Confederación Americana de Urología (CAU)

ObjectiveTo describe the trends in the current management of urolithiasis in the Confederación Americana de Urología (CAU) setting to recognise patterns of clinical practice and identify educational needs. Material and methodAn online survey was created with 31 multiple-choice questions (Spanish and Portuguese) through www.caunet.org, which revealed demographic data, patterns of clinical practice and approaches for specific clinical conditions. ResultsA total of 463 practitioners from Brazil, Mexico, Argentina, Spain, Colombia, Chile and other countries (3.96% of the members of CAU) completed the survey. All participants performed some type of urolithiasis treatment: 98.5% performed semirigid ureteroscopy (URS), 83.8% performed percutaneous nephrolithotomy (PCNL), 78.2% performed flexible URS, and 67.2% performed extracorporeal lithotripsy. The youngest physicians tended to perform PCNL (P<.001), and the proportion of users of flexible URS was greater in the Portuguese countries (P=.037). The main energy source was laser (60.7%). Small-calibre PCNL was performed by 15.3% of the respondents, more often in university hospitals (P<.01) and by older practitioners (P<.01). Only 3.2% of the respondents used percutaneous access to the kidney guided exclusively by ultrasound, especially the older practitioners (P<.001). The supine position was used by 40.4% of the respondents, more often in Spain (P<.001) and in the university setting (P=.017). PCNL without nephrostomy was practiced by 3.9% of the respondents. For flexible URS, 19.2% of the respondents did not use ureteral access sheaths, and the older practitioners preferred thinner calibre sheaths (P<.001). ConclusionsThe management of lithiasis in the CAU setting follows a profile similar to that recognised in the European and American clinical guidelines, although there are interesting variations based on the practitioner's age and preferences. We identified potential areas for improvement in small-calibre PCNL and ultrasound-guided puncture.

Communication on Safety of Medicines in Europe: Current Practices and General Practitioners' Awareness and Preferences.

IntroductionNational competent authorities (NCAs) for medicines coordinate communication relating to the safety of medicines in Europe. The effectiveness of current communication practices has been questioned, particularly with regard to reaching general practitioners (GPs).ObjectiveThe aim of this study was to assess current European NCA safety communication practices and to investigate European GPs’ awareness of and preferences for safety communications on medicines.MethodsWeb-based surveys were distributed among European NCAs and healthcare professionals (HCPs). The survey among regulators was emailed to a representative of each of the 27 European countries participating in the Strengthening Collaboration for Operating Pharmacovigilance in Europe (SCOPE) Joint Action. HCPs from nine European countries (Denmark, Spain, Croatia, Ireland, Italy, The Netherlands, Norway, Sweden, and the UK) were asked about their preferences through a link to the survey on websites, in newsletters, and/or in a direct email. From this survey, data from GPs were used and descriptive analyses were conducted.ResultsCurrent NCA practices were reported for 26 countries. In 23 countries (88%), NCAs published direct healthcare professional communications (DHPCs, i.e. urgent communication letters for serious safety issues) on their website in addition to distribution to individual HCPs. Educational materials were available on the NCA’s website in 10 countries (40%), and 21 NCAs (81%) indicated they had their own bulletin/newsletter, which is often presented on the NCA’s website (15 countries; 60%). More than 90% of the 1766 GPs who completed the survey were aware of DHPCs. The most preferred senders of safety information were NCAs and professional bodies, while the preferred channels for keeping up to date with safety information were medicines reference books and clinical guidelines. GPs found the repetition of safety issues useful (range of 80% in the UK to 97% in Italy). Preference for an electronic copy rather than a hardcopy varied per country (36% in Sweden to 72% in Spain).ConclusionsNCAs use similar methods for safety communications on medicines. Most GPs were aware of urgent communications and preferred similar senders of safety communications; however, their preferences towards the format differed per country.Electronic supplementary materialThe online version of this article (doi:10.1007/s40264-017-0535-0) contains supplementary material, which is available to authorized users.

Value methodology – case studies within climate resilience and sustainability policy application

ABSTRACTDesign solutions addressing climate resilience and sustainable development are desired for policy application, yet often encounter friction within the design team as well as between designers and external community members. Factors include unfamiliarity with issues and strategies, resistance to innovation, and constraints of time and budget, among others. Here, we aimed to understand how design may be supported through adapting the established practice of Value Methodology to better address policy goals. Action research methods adapted the standard Value Methodology process by collecting community inputs and addressing second law considerations. Challenges related to stakeholder concerns, practitioner preferences, and uncertainty under future conditions, especially climate change, were addressed by applying Multi-Criteria Decision Analysis to elicit community value expressions. Absent detailed forecast or scenario analysis, entropy-based qualitative assessment was applied in proxy for resilient approaches. The adapted Value Methodology approach was applied for collaborative innovative design across green buildings, net-zero military installations, regional climate resilient infrastructure systems, and multi-state renewable energy developments. Examination of how and when parties shared inputs indicated general patterns revealing user acceptance. Through cumulative action research across multiple cases, our study revealed that entropy assessment aided systems-level problem-solving during community and designer workshops to guide problem definition, generate designs, and evaluate alternatives. Additionally, outcomes were improved when stakeholder input was obtained early and repeated iteratively. The main findings are drawn from practitioner and stakeholder responses which may provide input to shape further research and practical use in the field as design teams seek practical ways forward for complex assignments.

Improving well-being and outcomes for looked after children in Wales: a context sensitive review of interventions

Improving outcomes for looked after children and young people has been a longstanding concern in Wales. This article reports the findings of a scoping study which sought to identify interventions aimed at improving outcomes for looked after children that are effective or promising. The study was commissioned by an independent funding body to inform a £5 million investment programme for Wales. It comprised a rapid review of literature, informed through consultation with an expert advisory panel and groups of young people who had been in care. The article outlines the rapid review method, provides details of shortlisted interventions and describes the interventions subsequently approved for investment. It concludes that although there are many promising interventions which address the factors associated with poor outcomes for looked after children, the evidence base is weak. It is argued that decision-making on interventions should be informed by appraisal of the empirical evidence available, but should also be guided by professional judgement that considers the needs, priorities and preferences of service users, carers, practitioners and policy-makers.

Preferences of psychiatric practitioners for core symptoms of major depressive disorder: a hidden conjoint analysis.

According to ICD-10 and DSM-V, symptoms of depressive disorder are considered to be equally important for severity judgment. It was the goal to investigate the weight of selected symptom complexes for severity judgment. In workaday life severity judgment results from an overall impression rather than from calculating severity in different symptom complexes, separately. In fact, the drivers for overall judgment may not be known explicitly to the psychiatrist himself. A method of choice to resolve this is conjoint analysis. Based on the Montgomery-Asberg Depression Scale (MADRS) and the Sheehan Disability Scale (SDS) case vignettes were constructed. Different symptom severity in the domains mood, vegetative symptoms, cognition/inhibition, suicidality, and everyday functioning were worked into the vignettes. Different symptom complexes influence the severity judgment by clinical psychiatrists to a rather different extent. Mood has a greater impact on severity judgment than suicidality, cognition/inhibition, vegetative symptoms, and everyday functioning. We conclude that core complexes of major depressive disorder are valued with different clinical relevance by psychiatrists. Thus, diagnosis and appraisal of therapeutic efficacy are subject to individual preferences of clinical psychiatrists and prevalence and therapeutic efficacy may be over- or under-estimated unless these differences in preferences are taken into account.

Imaging in Patients with Bisphosphonate-Associated Osteonecrosis of the Jaws (MRONJ).

Background: Bisphosphonate-associated osteonecrosis of the jaws (MRONJ/BP-ONJ/BRONJ) is a commonly seen disease. During recent decades, major advances in diagnostics have occurred. Once the clinical picture shows typical MRONJ features, imaging is necessary to determine the size of the lesion. Exposed bone is not always painful, therefore a thorough clinical examination and radiological imaging are essential when MRONJ is suspected. Methods: In this paper we will present the latest clinical update on the imaging options in regard to MRONJ: X-ray/Panoramic Radiograph, Cone Beam Computed Tomography (CBCT) and Computed Tomography (CT), Magnetic Resonance Imaging (MRI), Nuclear Imaging, Fluorescence-Guided Bone Resection. Conclusion: Which image modality is chosen depends not only on the surgeon’s/practitioner’s preference but also on the available imaging modalities. A three-dimensional imaging modality is desirable, and in severe cases necessary, for extended resections and planning of reconstruction.

The needs and preferences of general practitioners regarding their CPD learning: a Free State perspective

Background: The Health Professions Council of South Africa (HPCSA) requires all registered Health Practitioners in South Africa to complete accredited learning opportunities, and provide proof thereof. CPD is the chosen model, which focuses on holistic development of the professional. The UFS Department of Family Medicine presents refresher courses for general practitioners, covering all relevant fields of interest.Aim: The aim of this study was to find reasons and possible solutions for the perceived lack of interest in refresher courses by determining general practitioners’ needs and preferences for CPD training.Methodology: A cross-sectional study design was chosen, whereby a systematic sample of 300 general practitioners registered with the HPCSA as doctors in the Free State were asked to complete a questionnaire. Needs and preferences regarding learning opportunities and factors influencing usage of these learning opportunities were assessed.Results: The responses from 60 participants revealed that g...

Concussion Care Practices and Utilization of Evidence-Based Guidelines in the Evaluation and Management of Concussion: A Survey of New England Emergency Departments.

Evidence-based clinical practice guidelines can facilitate proper evaluation and management of concussions in the emergency department (ED), often the initial and primary point of contact for concussion care. There is no universally adopted set of guidelines for concussion management, and extant evidence suggests that there may be variability in concussion care practices and limited application of clinical practice guidelines in the ED. This study surveyed EDs throughout New England to examine current practices of concussion care and utilization of evidence-based clinical practice guidelines in the evaluation and management of concussions. In 2013, a 32-item online survey was e-mailed to 149/168 EDs throughout New England (Connecticut, Rhode Island, Massachusetts, Vermont, New Hampshire, Maine). Respondents included senior administrators asked to report on their EDs use of clinical practice guidelines, neuroimaging decision-making, and discharge instructions for concussion management. Of the 72/78 respondents included, 35% reported absence of clinical practice guidelines, and 57% reported inconsistency in the type of guidelines used. Practitioner preference guided neuroimaging decision-making for 57%. Although 94% provided written discharge instructions, there was inconsistency in the recommended time frame for follow-up care (13% provided no specific time frame), the referral specialist to be seen (25% did not recommend any specialist), and return to activity instructions were inconsistent. There is much variability in concussion care practices and application of evidence-based clinical practice guidelines in the evaluation and management of concussions in New England EDs. Knowledge translational efforts will be critical to improve concussion management in the ED setting.

The needs and preferences of general practitioners regarding their CPD learning: a Free State perspective

Background: The Health Professions Council of South Africa (HPCSA) requires all registered Health Practitioners in South Africa to complete accredited learning opportunities, and provide proof thereof. CPD is the chosen model, which focuses on holistic development of the professional. The UFS Department of Family Medicine presents refresher courses for general practitioners, covering all relevant fields of interest.Aim: The aim of this study was to find reasons and possible solutions for the perceived lack of interest in refresher courses by determining general practitioners’ needs and preferences for CPD training.Methodology: A cross-sectional study design was chosen, whereby a systematic sample of 300 general practitioners registered with the HPCSA as doctors in the Free State were asked to complete a questionnaire. Needs and preferences regarding learning opportunities and factors influencing usage of these learning opportunities were assessed.Results: The responses from 60 participants revealed that general practitioners still prefer the lecture form of presentations in large or small groups. Topics that ranked highly were Infective Diseases, Cardiology and Respiratory Diseases. Respondents indicated that general practitioners prefer not to leave their practices unattended for an extended period of time.Conclusion: Free State general practitioners still prefer the traditional lecture-room style of learning. Their declared learning needs are in line with the regular ailments they encounter within their practices. Strategies to accommodate those who find it difficult to attend, due to time and distance concerns, should be considered.

Utilization of antihypertensive drugs in obesity-related hypertension: a retrospective observational study in a cohort of patients from Southern Italy.

BackgroundAlthough the pathophysiological mechanisms of arterial hypertension are different in obese and lean patients, hypertension guidelines do not include specific recommendations for obesity-related hypertension and, therefore, there is a considerable uncertainty on which antihypertensive drugs should be used in this condition. Moreover, studies performed in general population suggested that some antihypertensive drugs may increase body weight, glycemia and LDL-cholesterol but it is unclear how this impact on drug choice in clinical practice in the treatment of obese hypertensive patients. Therefore, in order to identify current preferences of practitioners for obesity-related hypertension, in the present work we evaluated antihypertensive drug therapy in a cohort of 129 pharmacologically treated obese hypertensive patients (46 males and 83 females, aged 51.95 ± 10.1 years) that came to our observation for a nutritional consultation.MethodsStudy design was retrospective observational. Differences in the prevalence of use of the different antihypertensive drug classes among groups were evaluated with χ2 square analysis. Threshold for statistical significance was set at p < 0.05.Results41.1 % of the study sample was treated with one, 36.4 % with two and the remaining 22.5 % with three or more antihypertensive drugs. In patients under single drug therapy, β-blockers, ACEIs and ARBs accounted each for about 25 % of prescriptions. The prevalence of use of β-blockers was about sixfold higher in females than males. Diuretics were virtually never used in monotherapy regimens but were used in more than 60 % of patients on dual antihypertensive therapy and in all patients assuming three or more drugs. There was no significant difference in the prevalence of use of any of the aforementioned drugs among patients with obesity of type I, II and III or between patients with or without metabolic syndrome.ConclusionsOur data show that no first choice protocol seems to be adopted in clinical practice for the treatment of obesity-related hypertension. Importantly, physicians do not seem to differentiate drug use according to the severity of obesity or to the presence of metabolic syndrome or to avoid drugs known to detrimentally affect body weight and metabolic profile in general population.

Knowledge acquisition and research evidence in autism: Researcher and practitioner perspectives and engagement

BackgroundGovernment policy and national practice guidelines have created an increasing need for autism services to adopt an evidence-based practice approach. However, a gap continues to exist between research evidence and its application. This study investigated the difference between autism researchers and practitioners in their methods of acquiring knowledge. MethodsIn a questionnaire study, 261 practitioners and 422 researchers reported on the methods they use and perceive to be beneficial for increasing research access and knowledge. They also reported on their level of engagement with members of the other professional community. ResultsResearchers and practitioners reported different methods used to access information. Each group, however, had similar overall priorities regarding access to research information. While researchers endorsed the use of academic journals significantly more often than practitioners, both groups included academic journals in their top three choices. The groups differed in the levels of engagement they reported; researchers indicated they were more engaged with practitioners than vice versa. ConclusionsComparison of researcher and practitioner preferences led to several recommendations to improve knowledge sharing and translation, including enhancing access to original research publications, facilitating informal networking opportunities and the development of proposals for the inclusion of practitioners throughout the research process.

Treatment method and restorative material preferences of dental practitioners

Abstract Objective: The present study is aimed to investigate the preference profiles of treatment methods used by private dental practitioners in Ankara for deep carious lesions of mature permanent teeth. Methods: Private dental practitioners (general/specialist), in five districts of Ankara, were provided with a questionnaire comprising demographic characteristics and their preferred treatment methods for two simulated clinical cases related to deep caries excavation technique for anterior (Case A) and posterior, permanent teeth (Case B) with restorative material choices. The questionnaire was delivered personally to the participants who accepted the invitation. Documentation was retrieved back at another appointment after 1–3 weeks intervals. Data were analyzed using frequency analysis and Chi-square tests. Results: A total of 371 dentists, aged 25–69 years, took part in the study representing a response rate of 51.38%. Valid responses were 328 (168 males and 160 females) due to incomplete questionnaires. In Case A, complete caries excavation was the preferred treatment method (62.5%) followed by stepwise excavation (28.4%). Dentists, who had an excessive workload, indicated a stepwise excavation treatment significantly less than the dentists who had less workload (P = 0.001). In Case B, the preferences were narrowly distributed between complete caries excavation (50.9%) and stepwise excavation (42.4%). Composite restoration (31.7%) was more selected than amalgam (27.1%) with complete excavation technique. Workload has no effect on the treatment options of the posterior tooth with deep dentin caries. Conclusion: Dentists mostly adopted traditional caries removal technique. There is no uniform treatment method of deep carious lesions among dentists in anterior and, especially in posterior regions in Ankara, Turkey.

Vasoactive Drugs and Hemodynamic Monitoring in Pediatric Cardiac Intensive Care: An Italian Survey.

Little is known about practitioner preference, the availability of technology, and variability in practice with respect to hemodynamic monitoring and vasoactive drug use after congenital heart surgery. The aim of this study was to characterize current hospital practices related to the management of low cardiac output syndrome (LCOS) across Italy. We issued a 22-item questionnaire to 14 Italian hospitals performing pediatric cardiac surgery. Electrocardiogram, invasive blood pressure, central venous pressure, pulse oximetry, diuresis, body temperature, arterial lactate, and blood gas analysis were identified as routine in hemodynamic monitoring. With regard to advanced hemodynamic monitoring, pulmonary arterial catheter and transpulmonary thermodilution were available in 43% of the centers, uncalibrated pulse contour methods in 29% of the centers, and transesophageal/transthoracic echocardiograms in all of the centers. Dopamine added to milrinone was the most frequent drug regimen for LCOS prevention after cardiopulmonary bypass. Overall, 86% of centers used milrinone alone as the initial treatment for LCOS with elevated systemic vascular resistances and levosimendan, the second preferred choice. In cases of LCOS with low vascular resistance, epinephrine was the first choice (10 centers), dopamine was the second choice (4 centers), followed by vasopressin and norepinephrine (3 centers). For treatment of LCOS with elevated pulmonary resistances, milrinone was the first choice (eight centers), followed by inhaled nitric oxide (five centers). The survey shows that advanced hemodynamic monitoring is rarely performed. The most commonly used vasoactive drugs are milrinone, levosimendan, dopamine, epinephrine, vasopressin, and norepinephrine. Guidelines on the topic are warranted.

An Approach to Urban Quarter Design Using Building Generative Design and Thermal Performance Optimization

Buildings thermal performance is influenced by the urban context, such as adjacent buildings shadows, block wind paths, or solar radiation reflection. For this reason, in this paper, an automated procedure is used to generate and optimize buildings’ thermal performance in a closed O-shape urban quarter with ten building blocks to determine the importance of including the surroundings in estimating the buildings’ thermal behavior. The overall shape of the urban quarter is pre-designed, being mainly residential, with several stores in the ground floor and limited to three levels. Each building will have four alternative designs created using a hybrid evolutionary strategy technique that generates building's floor plans according to practitioner's preferences and requirements. Then, a sequential variable optimization procedure coupled with dynamic simulation engine is used to explore the improvement potential of each solution by changing and adding several building elements. The final quarter design is determined by combining the best of all buildings’ solutions from thermal performance criteria.The results demonstrate the influence of urban context in the resulting building's thermal performance. Despite the building's shape is similar in the four solutions, these have significant thermal behavior difference due to their interior organization and position in the urban quarter. A comparison analysis is carried out between all building block designs. The buildings, which have exterior walls with openings facing south, have almost half degree-hours of thermal discomfort due to the combination of large openings and shading overhangs. It is also possible to conclude that generative tools, enhanced with optimization procedures, may help practitioners in designing more energy efficient buildings.

General Practitioner Preferences in Managing Care of Multiple Sclerosis Patients.

Multiple sclerosis (MS) is a lifelong neurological disorder requiring care in a variety of settings. The purpose of this study is to describe preferences of general practitioners (GPs) with regards to providing care for MS patients. A stratified sample of 900 GPs in the province of Quebec were sent a questionnaire, with 266 returning completed questionnaires. Respondents were surveyed about their preferences using four clinical scenarios describing hypothetical patients experiencing different stages of MS. Respondents were asked whether they would continue managing the patient themselves, formally refer the patient to a specialist, or seek specialist advice. In two scenarios representing stable courses, 40.9% and 61.6% of GPs, respectively, intended to manage the patient themselves. GPs who reported having experience with MS patients were more likely to report an intention to continue management. In one scenario, GPs operating in rural areas were less likely to consider management than those in the Montreal metropolitan area (odds ratio=0.422, 95% confidence interval 0.20-0.90). For MS patients with a stable disease course, an important proportion of GPs appear to be willing to manage long-term care for MS patients.