Improving GPs' knowledge of the benefits and harms of treatment to support decision making in multimorbidity: qualitative research and co-design of a novel electronic information resource
Treadwell J.
Background General practitioners (GPs) regularly prescribe prolonged treatments for long-term conditions. However, GPs may benefit from further understanding of the absolute benefits and harms of these treatments, enhancing their ability to engage in shared decision-making and manage multimorbidity and polypharmacy. Aim To produce and evaluate a website to provide information on the benefits and harms of treatments for long-term conditions in a way that can be understood by GPs and potentially integrated into their practice. Methods The study consisted of three parts. First, a qualitative interview study and framework analysis with GPs exploring their attitudes to and understanding of the quantitative benefits and harms of treatments. Second, a participatory co-design process to design the website, coupled with a pragmatic approach to evidence collation to provide clinical content. Finally, an exploratory evaluation study of the website using online focus groups. Results The interview study reported findings on GPs’ understanding of quantitative information on the benefits and harms of treatments which informed the co-design research. The co-design research resulted in the creation of a website, www.gpevidence.org, which presents complex scientific information on treatment effect sizes and the nature and quality of the relevant clinical evidence. The evaluation study showed that participating GPs were able to understand the clinical information on GP Evidence, and that in hypothetical scenarios this might change their prescribing practice. Some participants found some information confusing. There was limited evidence that this new information could be integrated into complex decision-making for multimorbidity and polypharmacy. Conclusion The aim of producing a website able to deliver information on the benefits and harms of treatments for long-term conditions to GPs was achieved. Further research is needed to evaluate the effect of GP Evidence in real-world practice.