Barriers to Clinical Practice Guideline Implementation Among Physicians: A Physician Survey.
barriers
clinical practice guidelines
implementation
Journal
International journal of general medicine
ISSN: 1178-7074
Titre abrégé: Int J Gen Med
Pays: New Zealand
ID NLM: 101515487
Informations de publication
Date de publication:
2021
2021
Historique:
received:
18
08
2021
accepted:
04
10
2021
entrez:
10
11
2021
pubmed:
11
11
2021
medline:
11
11
2021
Statut:
epublish
Résumé
Clinical practice guidelines can help physicians provide evidence-based, standardized clinical decisions. We aimed to assess physician attitudes toward and barriers to guideline adherence. We conducted a single center, cross-sectional, survey-based study. Physicians from many specialties participated in the study. All outcomes were measured using a validated survey tool. The primary outcome of interest was barriers to guideline adherence. Secondary outcomes included general attitudes toward guidelines and factors that could improve adherence to guidelines. Outcomes were measured by the survey tool. All outcomes were reported on a 5-point Likert scale. The email survey was received by 1819 physicians with 400 responders (22% response rate). About 50% (n=200) were in practice for >5 years, while 27% (n=107) were still in training. Trainees were less likely to understand the process of guideline development (RR= 0.76 [0.65-0.88], p=0.0017), to have input in guideline development (RR= 0.52 [0.41-0.65], p<0.0001), and to report up-to-date knowledge in practice guidelines (RR=0.53 [0.30-0.73], p=0.0002). Three factors were identified as major barriers to guideline adherence: complexity of guideline documents (61%, n=240), high number of weak or conditional recommendations (62%, n=245), and time constraints due to clinical responsibilities (65%, n=255). Factors that would improve guideline adherence included access to relevant guidelines at the point of care (87%), improved focus on guidelines during training (82%), and transparency on physician commercial affiliation (62%). Improved focus on guidelines during training and access to relevant guidelines at the point of care may be important to improve adherence to guidelines.
Identifiants
pubmed: 34754231
doi: 10.2147/IJGM.S333501
pii: 333501
pmc: PMC8572046
doi:
Types de publication
Journal Article
Langues
eng
Pagination
7591-7598Informations de copyright
© 2021 Qumseya et al.
Déclaration de conflit d'intérêts
Dr. Draganov is a consultant for Olympus, Boston Scientific, Cook Medical, Lumendi and Microtech. The authors declare that they have no other conflicts of interest in this work.
Références
J Biomed Inform. 2009 Apr;42(2):377-81
pubmed: 18929686
Am J Transplant. 2020 Mar;20(3):797-807
pubmed: 31730286
Gastrointest Endosc. 2018 Apr;87(4):932-933
pubmed: 29571779
Gastroenterology. 2020 Sep;159(3):1085-1094
pubmed: 32810434
Clin Infect Dis. 2001 Mar 1;32(5):728-41
pubmed: 11229840
BMC Med Res Methodol. 2015 Apr 09;15:32
pubmed: 25888346
JAMA. 1999 Oct 20;282(15):1458-65
pubmed: 10535437
Am J Med. 1999 Jun;106(6):636-41
pubmed: 10378621
Implement Sci. 2009 Sep 21;4:59
pubmed: 19772570
Cad Saude Publica. 2008 Feb;24(2):253-66
pubmed: 18278272
BMC Med Inform Decis Mak. 2008 Sep 12;8:38
pubmed: 18789150
J Clin Epidemiol. 2013 Jul;66(7):719-25
pubmed: 23312392
JAMA Netw Open. 2020 Mar 2;3(3):e200841
pubmed: 32167566
Gastrointest Endosc. 2019 Sep;90(3):335-359.e2
pubmed: 31439127
Am J Med. 2001 Apr 15;110(6):451-7
pubmed: 11331056
Ann Fam Med. 2014 May-Jun;12(3):202-3
pubmed: 24821890
Chest. 2018 Apr;153(4):954-985
pubmed: 29374513
Am J Gastroenterol. 2003 Jun;98(6):1410-6
pubmed: 12818289
Int J Environ Res Public Health. 2020 Sep 14;17(18):
pubmed: 32938004
J Clin Epidemiol. 2011 Apr;64(4):383-94
pubmed: 21195583