gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

What are family physicians' perceptions of guideline implementation and uptake? A qualitative study

Meeting Abstract

  • M. Kastner - St. Michael's Hospital, Li Ka Shing Knowledge Institute, Toronto, Canada
  • L. Hayden - St. Michael's Hospital, Li Ka Shing Knowledge Institute, Toronto, Canada
  • A. Chatterjee - St. Michael's Hospital, Li Ka Shing Knowledge Institute, Toronto, Canada
  • A. Grudniewicz - St. Michael's Hospital, Li Ka Shing Knowledge Institute, Toronto, Canada
  • E. Estey - Strategic Policy, Planning & Initiatives, Health Services, Region of Peel, Toronto, Canada
  • O. Bhattacharyya - St. Michael's Hospital, Li Ka Shing Knowledge Institute, Toronto, Canada

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocO12

DOI: 10.3205/12gin044, URN: urn:nbn:de:0183-12gin0445

Veröffentlicht: 10. Juli 2012

© 2012 Kastner et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background: Guidelines are not consistently implemented and can be confusing and difficult to use.

Objectives: As guideline characteristics are best assessed by end-users, the current study explored how family physicians perceive guideline implementability, and which attributes may comprise an implementability tool.

Methods: We conducted a qualitative study of interviews with community and academic family physicians, selected from a Canadian physician society database and a targeted family practice at St. Michael’s Hospital in Toronto. Two investigators conducted the interviews using semi-structured, open-ended questions to reveal facilitators and barriers to guideline use, to obtain feedback on draft guideline recommendations, and to suggest ideas to build a tool to enhance guideline implementability. Sessions were audio taped, and transcribed data were analyzed independently by 3 sets of investigators using grounded theory methodology.

Results: Twenty family physicians were interviewed. Informants preferred recommendations that are quickly accessible, concise, and have clear statements on diagnosis and management (e.g., clear decision tree); and formats that replicate their own clinical decision-making. Tool suggestions included a process to facilitate end-user involvement in the guideline development process, and to provide on-line resources and continuing medical education credits as incentives to encourage participation.

Discussion: Attributes described by participants were consistent with 3 of the 5 implementability dimensions found in our realist review investigating guideline implementability: language, format, and evidence.

Implications for guideline developers/users: This study represents a novel contribution to guideline implementability, as it provides empirical support for an implementability framework derived from a realist review.