Barriers in the Implementation of Clinical Guidelines in Diabetes Management: Physicians’ Experiences in Bisha, Saudi Arabia

Abstract

Introduction: Currently, the number of people living with diabetes in Saudi Arabia is less than one in every ten individuals and this number is expected to double in the next 20 years, which entails frequent and thorough investigation of implementation and effectiveness of the disease management guidelines. Aim: To explore the knowledge and barriers in implementation of the clinical guidelines in diabetes management among the physicians in Bisha, Saudi Arabia. Materials and Methods: In this cross-sectional study, data were collected using structured questionnaire, from a convenient sample of 149 physicians working at several health centers in Bisha, Saudi Arabia from May 2021 to July 2021. The implementation of clinical guidelines according to physician’s gender, years of experience, specialty, workplace, and professional status was statistically assessed using MannWhitney test, Chi-square test, Kruskal-Wallis test and Spearman test. The data was imported to an Excel sheet, coded and analysed using Statistical Package for Social Sciences (SPSS) (IBM version 20). Results: The results showed no significant relationship between guideline use and assessed variables except for years of experience, indicating that work experience influences practitioners’ impressions and attitudes towards clinical guidelines (0.001). The study also disclosed some barriers to implementing the clinical guidelines, including lack of familiarity (mean=3.483; median=4) and awareness (mean=3.637; median=4). The results also showed that the minor challenges included a lack of confidence in guideline developers (mean=2.557; median=2), lack of outcome expectancy in patient care (mean=2.7114; median=2) and a lack of agreement with guidelines because they were not up to date (mean=2.591; median=2). Conclusion: The findings concluded that physicians were well aware of the American Diabetes Association standards, demonstrating their popularity and ease of use in Saudi Arabia.