Abstrakt
Objectives Clinical practice guidelines are intended to improve and optimize outcomes of patient care. However, their uptake remains a challenge.
Our study aims to identify barriers and factors that influence the effective implementation of guidelines into clinical practice of Czech general practitioners (GPs). Methods We conducted questionnaire survey.
Questioner was validated by a sample of Czech GPs and disseminated between GPs who were randomly selected. Results Of the 77 Czech GPs, respondents were mostly women (43, 55.8%) with median age of 55 years (range 27-71 years) and with 28 years of clinical practice (median; range 1.5-45 years).
Though GPs attitude toward clinical practice guidelines is positive (71/74, 95.9% positive; 3/71, 4.1% neither positive nor negative) and guidelines are perceived as a useful information source (68/74, 91.9%), they are still in 35.6% (26/73) perceived as not applicable in daily clinical practice and in 28.2% (20/71) as a restricting therapeutic freedom. From "Individual and professional domain" was time (51/70, 72.9%) and skills (40/70, 57.1%) identified as a key barriers that influence the integration of evidence-based medicine into practice, from "Social context" it was pressure to do same as colleagues (17/39, 43.6%), from "Characteristics of the organisation" it was legislation restrictions (24/46, 52.2%) and from "Characteristics of the evidence-based medicine" it was lack of clear presentation (23/52, 44.2%) and too difficult/theoretical to apply into practice (26/52, 50.0%).
Conclusions This study has provided data on barriers to implement clinical guidelines into practice. Since plans for better implementation of guidelines usually require more thought and effort than does drawing them up, we believe that our results offers some key information that might be carefully considered when other evidence-based clinical practice guidelines for GPs are to be put into effect.