Use of clinical practice guidelines and factors related to their uptake: a survey of health professionals in Spain
Por:
Kotzeva, A, Guillamon, I, Gracia, J, del Campo, PD, Gich, I, Calderon, E, Gaminde, I, Louro-Gonzalez, A, Martinez, F, Orrego, C, Rotaeche, R, Salcedo, F, Alonso-Coello, P
Publicada:
1 jun 2014
Resumen:
Rationale, aims and objectiveThis study aims to assess the use of clinical practice guidelines (CPGs) among health professionals and factors related to their uptake in clinical practice.
MethodsCross-sectional study based on an online survey conducted among primary care (PC) and hospital-based care (HC) doctors in Spain in 2011. Questionnaire development included adaptation of similar surveys and contextualization through a qualitative study. After a pilot study and review, the final survey contained five domains: demographics, involvement in CPGs, consultation of CPGs, perceptions and attitudes regarding CPGs and Spanish NHS CPGs Programme. Professionals from selected health care centres in seven regions were contacted by email with an invitation and link to the Web-based questionnaire. We analysed between-group differences and explored potential predictors of CPGs use by means of a logistic regression.
ResultsSix hundred seventy-six doctors responded to the survey (27.7% response rate). 47.1% were PC and 49.5% were HC doctors. 32.5% stated previous involvement in CPGs and 56.5% stated training in research methodology. 67.5% of the surveyed professionals reported using CPGs more than one time per week. The use of a system for classifying the quality of evidence (62.3%) and for grading the strength of the recommendations (58.6%), as well as the use of a rigorous methodology (49.6%), were the most frequently reported aspects related to CPG credibility. The lack of time (56.4%), especially in PC (65.3% versus 49.5% in HC; P<0.001), and the absence of brief and easily accessible format (42.2%) were the main reported barriers to using CPGs. None of the studied factors showed statistically significant association in the logistic regression model.
ConclusionsStudy results suggest that, in general, Spanish doctors trust and use CPGs frequently. To improve uptake by health professionals and to overcome existing barriers, CPGs should be rigorously developed and made accessible at the point-of-care in user-friendly electronic formats. Due to the low response rate, findings should be extrapolated with caution.
Filiaciones:
Kotzeva, A:
Agcy Hlth Qual & Assessment Catalonia AQuAS, Barcelona, Spain
CIBERESP, Madrid, Spain
Guillamon, I:
Agcy Hlth Qual & Assessment Catalonia AQuAS, Barcelona, Spain
CIBERESP, Madrid, Spain
Gracia, J:
Natl CPG Programme NHS, Chair Sci Comm GuiaSalud, Madrid, Spain
del Campo, PD:
UETS, Reg Hlth Council, Hlth Technol Assessment Unit, Hlth Technol & Innovat Gen Subdirectorate, Madrid, Spain
Gich, I:
Univ Autonoma Barcelona, Dept Pharmacol & Therapeut, E-08193 Barcelona, Spain
Calderon, E:
CIBERESP, Madrid, Spain
Univ Seville, Inst Biomed Sevilla, Hosp Univ Virgen del Rocio, CSIC, Seville, Spain
Gaminde, I:
Govt Navarre, Dept Hlth, Innovat & Continuous Educ Unit, Pamplona, Navarre, Spain
Louro-Gonzalez, A:
SERGAS, Ctr Saude Cambre, Xerencia Atenc Primaria A Coruna, La Coruna, Spain
Martinez, F:
Andalusian Reg Minist Hlth & Social Well Being, Gen Secretariat Publ Hlth Social Inclus & Qual Li, Seville, Spain
Orrego, C:
Univ Autonoma Barcelona, Avedis Donabedian Res Inst FAD, E-08193 Barcelona, Spain
Red Invest Serv Salud Enfermedades Cron REDISSEC, Madrid, Spain
Rotaeche, R:
Ctr Salud Alza, Grp Kronikgune Gest Conocimiento, Donostia San Sebastian, Spain
Salcedo, F:
Inst Aragones Ciencias Salud, Zaragoza, Spain
Alonso-Coello, P:
CIBERESP, Madrid, Spain
Hosp Santa Creu & Sant Pau, Iberoamer Cochrane Ctr, Clin Epidemiol & Publ Hlth Dept, Barcelona, Spain
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