Abstract
Medical guidelines aim to ensure that care processes take place in an evidence-based and structured manner. They are especially relevant in outpatient primary care due to the wide range of symptoms and clinical pictures. In German-speaking countries, there is a lack of current findings documenting general practitioners’ opinions and experiences regarding guidelines, their expectations and their views on what improvements could be made to increase the use of this type of evidence-based instrument in the primary care setting. Between April and August 2020, a total of 3098 general practitioners were surveyed in the states of Baden–Württemberg, Hesse and Rhineland–Palatinate via an online questionnaire. Alongside the descriptive evaluation, t‑testing was used to determine significant differences between two independent sampling groups. A factor analysis was also used to cluster the expectations of those surveyed regarding the fulfilment of requirements relating to guidelines. A total of 52% of those surveyed have a positive view of guidelines. Overall, guidelines are associated with an increased evidence-based approach (69%), standardisation of diagnosis and treatment (62%) and a reduction in overprovision or underprovision of care (57%). In all, 62% of the physicians who implemented guidelines observed positive effects on the quality of care provided, and 67% reported that the implementation of guidelines improved the quality of their diagnostic or therapeutic skills. However, implementation is often seen as being complicated (43%) and restricting the physician’s ability to act independently (63%). Survey participants suggested that guidelines could be optimised by giving greater consideration to nondrug alternatives (46%), focusing on issues related to quality of life (42%) and offering a comparative assessment of various treatment options (39%). In order to further promote the attractiveness of guidelines for primary care the design of guidelines should be oriented more towards their application; they should be well-presented to make them easier to implement. The scope of action available to the physician should be stressed. The guidelines should provide recommendations on opportunities for the delegation of tasks within practice teams.Supplementary InformationThe online version of this article (10.1007/s10354-021-00849-3) contains supplementary material, which is available to authorized users.
Highlights
Clinical guidelines are considered as an important instrument for effective, practical and evidence-based care provision [1,2,3]
It was demonstrated that many general practitioners see that implementing guidelines offers significant benefits to patient care
The question of the distribution and implementation of primary care guidelines is based on complex research, evaluation, planning, and implementation processes
Summary
Clinical guidelines are considered as an important instrument for effective, practical and evidence-based care provision [1,2,3]. The guidelines of the scientific medical societies can be described as systematically developed aids for medical decision-making that provide concrete recommendations for action. They are based on current scientific knowledge and methods that have been tried and tested in practice and aim to ensure more safety in patient care, and take economic aspects into account. Clinical guidelines are not legally binding for physicians and neither establish nor discharge liability
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