Smith, SG orcid.org/0000-0003-1983-4470, Side, L, Meisel, SF et al. (3 more authors) (2016) Clinician-reported barriers to implementing breast cancer chemoprevention in the UK: A qualitative investigation. Public Health Genomics, 19 (4). pp. 239-249. ISSN 1662-4246
Abstract
Aims: The use of tamoxifen and raloxifene as preventive therapy for women at increased risk of breast cancer was approved by the National Institute for Health and Care Excellence (NICE) in 2013. We undertook a qualitative investigation to investigate the factors affecting the implementation of preventive therapy within the UK. Methods: We recruited general practitioners (GPs) (n = 10) and clinicians working in family history or clinical genetics settings (FHCG clinicians) (n = 15) to participate in semi-structured interviews. Data were coded thematically within the Consolidated Framework for Implementation Research. Results: FHCG clinicians focussed on the perceived lack of benefit of preventive therapy and difficulties interpreting the NICE guidelines. FHCG clinicians felt poorly informed about preventive therapy, and this discouraged patient discussions on the topic. GPs were unfamiliar with the concept of preventive therapy, and were not aware that they may be asked to prescribe it for high-risk women. GPs were reluctant to initiate therapy because it is not licensed, but were willing to continue a prescription if it had been started in secondary or tertiary care. Conclusions: Barriers to implementing preventive therapy within routine clinical practice are common and could be addressed by engaging all stakeholders during the development of policy documents.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2016 The Author(s). Published by S. Karger AG, Basel. This article is licensed under the Creative Commons Attribution 4.0 International License (CC BY) (http://www.karger.com/Services/OpenAccessLicense). Usage, derivative works and distribution are permitted provided that proper credit is given to the author and the original publisher. |
Keywords: | Consolidated Framework for Implementation Research; Chemoprevention; Breast cancer prevention; Preventive therapy; Qualitative investigation |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Primary Care (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 30 Jan 2017 15:00 |
Last Modified: | 05 Oct 2017 16:22 |
Published Version: | https://doi.org/10.1159/000447552 |
Status: | Published |
Publisher: | Karger Publishers |
Identification Number: | 10.1159/000447552 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:111320 |