gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

Does Physicians’ knowledge of guidelines lead to better guideline implementation? An Exploratory Study in Cardiovascular Diseases

Meeting Abstract

  • U. Karbach - Institute of medical Sociology, Health Services Research and Rehabilitation Scie, Cologne, Germany
  • I. Schubert - PMV forschungsgruppe, University of Cologne, Cologne, Germany
  • J. Hagemeister - Department III for Internal Medicine, University of Cologne, Cologne, Germany
  • N. Ernstmann - Institute of medical Sociology, Health Services Research and Rehabilitation Scie, Cologne, Germany
  • H. Pfaff - Institute of medical Sociology, Health Services Research and Rehabilitation Scie, Cologne, Germany
  • H. W. Höpp - Department III for Internal Medicine, University of Cologne, Cologne, Germany

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP137

DOI: 10.3205/12gin249, URN: urn:nbn:de:0183-12gin2490

Published: July 10, 2012

© 2012 Karbach et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Background: Studies have shown, however, that guidelines are still not being adequately implemented. In this exploratory study, we examine the link between physicians’ knowledge of and compliance with guidelines: specifically, guidelines for the treatment of three cardiovascular diseases (arterial hypertension, heart failure and chronic coronary heart disease [CHD]) in primary care.

Methods: We assessed primary care physicians’ knowledge of the guidelines with a representative postal survey, using a questionnaire about the treatment of cardiovascular diseases (2,500 questionnaires sent). We assessed the responding physicians' compliance with the guidelines by analyzing patient data from a sample of 30 of them for various indicators of compliance. Of these 30 physicians, 15 met our operational criteria for adequate knowledge of the guidelines, and 15 did not.

Results: 437 (40%) of the physicians knew the guidelines adequately. Physicians answered questions about chronic CHD in accordance with the guidelines more often than they did questions about arterial hypertension (74% versus 11%). Our exploratory analysis of guideline compliance revealed that physicians who knew the guidelines adequately performed no differently than physicians who did not with respect to 12 of the 16 compliance indicators. As for the remaining 4 compliance indicators, it turned out, surprisingly, that physicians who did not know the guidelines adequately performed significantly better than those who did.

Conclusion: These preliminary findings imply that physicians’ knowledge of guidelines does not in itself lead to better guideline implementation. Further studies are needed to address this important issue. Our results have been published