Abstract
Aims: Increasing focus on improvement and optimisation of the treatment in primary care and reduction of healthcare costs emphasize the need to understand which factors determines adherence and non-adherence to clinical guidelines. In the present study, we examined attitudes towards clinical guidelines in Danish general practitioners (GPs). Methods: We conducted a survey among Danish GPs from all five regions of Denmark. In total, 443 GPs answered the web-based questionnaire that contained questions about attitudes and barriers to clinical guidelines. Results: More than 90% of the GPs reported that they have good knowledge of the guidelines and in general follows the guidelines. A majority of the GPs (81%) found it acceptable that economic considerations are part of the guidelines. The most important factors for non- adherence to guidelines were “need of adjustment to clinical practice” and “lack of confidence in guidelines”. The attitudes to clinical guidelines were not significantly associated with practice characteristics such as gender, years of experience, practice organisation and localisation. Conclusions: Our findings show that clinical guidelines are an integrated or internalised part of everyday practice among GPs in Denmark. Furthermore, the findings indicate that Danish GPs are positive towards applying priority setting in their practice. This is decisive in the light of rising healthcare costs due to development of new expensive technologies and ageing populations that puts pressure on the healthcare system in general and primary healthcare in particular.
Highlights
The definition of clinical practice guidelines is “systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances” [1].Francke et al conducted in 2008 a meta-review to understand which factors that affect the implementation of guidelines [2]
The vast majority of the general practitioners (GPs) report that they use guidelines is well aware of the guidelines, and have confidence in guidelines from the government and the medical societies
These findings indicate that clinical guidelines are an integrated or internalised part of the everyday practice among GPs in Denmark
Summary
The definition of clinical practice guidelines is “systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances” [1].Francke et al conducted in 2008 a meta-review to understand which factors that affect the implementation of guidelines [2]. In 2010, the Danish Medical Association conducted a survey about use of clinical guidelines among 1675 clinicians within a wide range of specialties. The study showed that format, accessibility and appropriate implementation strategies are crucial to successful implementation and use of clinical guidelines among clinicians. The views that emerged from this study were that GPs found it difficult to keep updated on new treatments and research evidence and some of the GPs expressed that they missed a single comprehensive source of guidelines. Another key finding was that the GPs sometimes experienced a dilemma between standardisation practice and individual treatment of the patient.
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