Management of patients with sore throats in relation to guidelines: an interview study in Sweden

Scand J Prim Health Care. 2014 Dec;32(4):193-9. doi: 10.3109/02813432.2014.972046. Epub 2014 Nov 3.


Objective: To explore how a group of Swedish general practitioners (GPs) manage patients with a sore throat in relation to current guidelines as expressed in interviews.

Design: Qualitative content analysis was used to analyse semi-structured interviews.

Setting: Swedish primary care.

Subjects: A strategic sample of 25 GPs.

Main outcome measures: Perceived management of sore throat patients.

Results: It was found that nine of the interviewed GPs were adherent to current guidelines for sore throat and 16 were non-adherent. The two groups differed in terms of guideline knowledge, which was shared within the team for adherent GPs while idiosyncratic knowledge dominated for the non-adherent GPs. Adherent GPs had no or low concerns for bacterial infections and differential diagnosis whilst non-adherent GPs believed that in patients with a sore throat any bacterial infection should be identified and treated with antibiotics. Patient history and examination was mainly targeted by adherent GPs whilst for non-adherent GPs it was often redundant. Non-adherent GPs reported problems getting patients to abstain from antibiotics, whilst no such problems were reported in adherent GPs.

Conclusion: This interview study of sore throat management in a strategically sampled group of Swedish GPs showed that while two-thirds were non-adherent and had a liberal attitude to antibiotics one-third were guideline adherent with a restricted view on antibiotics. Non-adherent GPs revealed significant knowledge gaps. Adherent GPs had discussed guidelines within the primary care team while non-adherent GPs had not. Guideline implementation thus seemed to be promoted by knowledge shared in team discussions.

Keywords: General practice; Sweden; general practitioners; guidelines; qualitative research; sore throat.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Disease Management
  • Drug Prescriptions
  • Family Practice / methods
  • Female
  • Guideline Adherence / standards*
  • Humans
  • Male
  • Middle Aged
  • Pharyngitis / drug therapy*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Qualitative Research
  • Sweden / epidemiology


  • Anti-Bacterial Agents