GUIDELINES FOR DYSPEPSIA MANAGEMENT IN GENERAL-PRACTICE USING FOCUS GROUPS

Background. There is a paucity of published guidelines on managing dys pepsia in general practice. Existing guidelines emphasize the role of investigations and drugs rather than management approaches. Focus grou ps are a means of uncovering the way in which the participants think a nd work in the pragmatic setting, and have not previously been formall y used in creating guidelines. Aim. To develop guidelines for the mana gement of dyspepsia and to assess the use of focus groups of general p ractitioners (GPs) in order to do so. Method. Initial evidence-based g uidelines were proposed by a group of four GPs with an audit facilitat or, and used for discussion in three focus groups using a standard for mat. An anthropological analysis of the proceedings led to modificatio ns of the original guidelines, based on knowledge, perceptions and att itudes. The study was set in three distinct locations involving 30 GPs . The outcome measures consisted of feedback, categorized by types of responses, from the analysis of the focus groups and the creation of g uidelines. Results. The resulting guidelines were patient centred and based on the principles of good consultation. They encompassed patient s' fears and doctors' clinical uncertainties, and allowed flexibility in the individual patient's manage ment. The focus group methodology e xposed a substantial number of GPs to guideline development, and had;h e added benefits of dissemination, peer review and educational challen ge. Conclusion. It was possible to develop guidelines for dyspepsia us ing focus groups. The methodology had the added benefits of ownership, peer review, exposure of educational gaps and locality factors, and d issemination of good practice. It included steps from evidence review to implementation strategies. The development of this technique could lead to a strategy towards the creation and application of evidence-ba sed and professionally acceptable clinical guidelines and practice on a locality basis nationally.