|About the Book|
Clinical practice guidelines were developed within the context of evidence-based medicine with the goal of putting medical research findings into practice. However, physicians do not always follow them. Of course, often the guidelines do not apply toMoreClinical practice guidelines were developed within the context of evidence-based medicine with the goal of putting medical research findings into practice. However, physicians do not always follow them. Of course, often the guidelines do not apply to the particular condition the physician has to treat, but this is not always the case. This phenomenon, known as clinical inertia, was brought to light about ten years ago and represents a significant obstacle to the efficiency of care and a major public health problem, the extent of which is demonstrated in this book. Evidence-based medicine forces us to reconsider the role of the human factor in creating this gap between guidelines and reality. An analysis of its causes shows that it results from a divergence between two factors that influence the physicians decision to implement this new way of practicing medicine. On the one hand there is the objective, essentially statistical, influence of large clinical trials, on the other hand there is the physicians own complex, subjective view, referred to here as medical reason. This book shows how, and at what price, these two factors can be reconciled. The author is a diabetologist and Professor of Endocrinology, Diabetology and Metabolic Diseases at the Paris 13-University. He has also published Pourquoi Se soigne-t-on, Enqu te sur la rationalit morale de lobservance (2007), Clinique de lObservance, LExemple des diab tes (2006), and Une th orie du soin, Souci et amour face la maladie (2010). An English adaptation of the first book is published by Springer (Philosophy and Medicine) under the title: The Mental Mechanisms of Patient Adherence to Long Term Therapies, Mind and Care.