[A study of the use of clinical practice guidelines in specialized care: barriers and facilitators to implementation]

Arcelay A, Iruretagoyena ML, Reviriego E
Record ID 32018000592
Original Title: Estudio sobre la utilización de las guías de práctica clínica en atención especializada. Exploración de barreras y facilitadores para su implementación
Authors' objectives: •  To determine the degree of understanding, use and adherence to, as well as the attitudes of specialized care professionals within the Basque Health Service (Osakidetza) towards, CPGs. •  To identify the most relevant barriers and facilitators to their correct dissemination and implementation. •  To identify the strategies and improvement actions that may contribute to minimizing the impact of those barriers detected.
Authors' results and conclusions: The questionnaire was completed by 209 specialized care physicians from the three regions within the Autonomous Community of the Basque Country. The clinical practice guidelines best known to the participants were those issued by scientific societies and international organizations (86.1% and 78.5%, respectively), whereas those issued by Osakidetza were less well known (68.4%). Almost two thirds of those surveyed (63.6%) stated that CPGs were used in their department. A total of 61.2% of participants considered that application of the recommendations in the CPGs was easy, whereas 28.2% considered this to be difficult. The reasons provided to explain this difficulty included difficulties in their practical application, a lack of organizational, financial and infrastructure-related resources, the variable nature of the patients, a lack of time, little evidence regarding some questions with low-quality recommendations, disagreement, a lack of interest and motivation, and a lack of awareness of the CPGs due to their poor dissemination. The strategies considered best suited to increasing and improving the use of CPGs were specific training programs (68.4%), participation of professionals themselves in the generation of scientific evidence (51.7%) and, to a lesser extent, the adaptation of previously published guidelines (41.6%). CONCLUSIONS Overall, two thirds of the professionals who took part in the survey were aware of the guidelines issued by Osakidetza/Department of Health and Consumer Affairs. However, although the degree of awareness of the CPGs issued can be considered to be positive, it is nevertheless important to highlight their dissemination/implementation strategies. Thus, although the participants stated that they were aware of the existence of guidelines in daily clinical practice, a series of internal barriers related to the healthcare professional and external barriers related to the social context and/or health system in which they are to be used have been detected. It is therefore necessary to develop strategies aimed at improving the dissemination and implementation of such CPGs and to establish different actions targeting both instrumental aspects and those related to the healthcare professionals and the barriers detected.
Authors' methods: In order to meet the study’s objectives, it is essential to discover the opinion of those persons actively involved in the creation, dissemination and use of CPGs. As a result, a decision was taken to distribute a specific questionnaire in order to discover the level of understanding and the attitudes of healthcare professionals working in specialized care towards clinical practice guidelines. The questionnaire was sent to 1590 professionals from the different specialities covered by the guidelines published by Osakidetza over the past few years. A questionnaire structured in four dimensions, namely awareness of the CPGs, their use, practical applicability and improvement strategies, was used.
Project Status: Completed
Year Published: 2013
English language abstract: An English language summary is available
Publication Type: Other
Country: Spain
MeSH Terms
  • Practice Guidelines as Topic
  • Information Dissemination
  • Implementation Science
  • Disease Management
  • Health Plan Implementation
  • Clinical Practice Guideline
  • Hospitals
  • Health Personnel
  • Information Dissemination
  • Health Plan Implementation
  • Surveys and Questionnaires
  • Encuestas y Cuestionarios
  • Implementación de Plan de Salud
  • Difusión de la Información
  • Personal de Salud
  • Hospitales
  • Guía de Práctica Clínica
Organisation Name: Basque Office for Health Technology Assessment
Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz
Contact Name: Lorea Galnares-Cordero
Contact Email: lgalnares@bioef.eus
Copyright: Osteba (Basque Office for Health Technology Assessment) Health Department of the Basque Government
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.