Do Urologists Adhere to the British National Formulary (BNF) Guidelines?—Results of a Postal Questionnaire Survey

Abstract

Aim: Information in the British National Formulary (BNF) is obtained from a wide range of sources. BNF contains three guidelines directly pertinent to urological practice. We set out to determine urologists' adherence to these guidelines. Methods: A standard questionnaire was sent to each urological unit in the UK ( n = 191). The three guidelines relate to: Prevention of endocarditis in patients undergoing urological interventions. Use of iodine containing contrast media in patients taking metformin. Use of anti-androgens in conjunction with GnRH analogues. Results: 111 (58%) completed questionnaires were returned. Adherence rate was 28%, 34% and 17% respectively for each of the above guidelines. The adherence rate was 50%, 50% and 14% by specialist registrars in contrast to 22%, 27% and 16% by consultants. Adherence decreased as the number of years of experience in urology increased, from 36.3% at 5 years to 26.3% at 20 years. Conclusion: The overall adherence of urologists to BNF guidelines is low (26.3%), with adherence being higher for registrars. The longer a urologist had been in urology, the lower the adherence. In the current era of evidence-based practice, we recommend that these guidelines are revisited, perhaps by the British Association of Urological Surgeons or National Institute for Clinical Excellence.