Clinicians evaluations of, endorsements of, and intentions to use practice guidelines change over time: a retrospective analysis from an organized guideline programReportar como inadecuado




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Implementation Science

, 4:34

First Online: 28 June 2009Received: 22 August 2008Accepted: 28 June 2009DOI: 10.1186-1748-5908-4-34

Cite this article as: Brouwers, M., Hanna, S., Abdel-Motagally, M. et al. Implementation Sci 2009 4: 34. doi:10.1186-1748-5908-4-34

Abstract

PurposeClinical practice guidelines CPGs can improve clinical care but uptake and application are inconsistent. Objectives were: to examine temporal trends in clinicians- evaluations of, endorsements of, and intentions to use cancer CPGs developed by an established CPG program; and to evaluate how predictor variables clinician characteristics, beliefs, and attitudes are associated with these trends.

Design and methodsBetween 1999 and 2005, 756 clinicians evaluated 84 Cancer Care Ontario CPGs, yielding 4,091 surveys that targeted four CPG quality domains rigour, applicability, acceptability, and comparative value, clinicians- endorsement levels, and clinicians- intentions to use CPGs in practice.

ResultsTime: In contrast to the applicability and intention to use in practice scores, there were small but statistically significant annual net gains in ratings for rigour, acceptability, comparative value, and CPG endorsement measures p < 0.05 for all rating categories. Predictors: In 17 comparisons, ratings were significantly higher among clinicians having the most favourable beliefs and most positive attitudes and lowest for those having the least favourable beliefs and most negative attitudes p < 0.05. Interactions Time × Predictors: Over time, differences in outcomes among clinicians decreased due to positive net gains in scores by clinicians whose beliefs and attitudes were least favorable.

ConclusionIndividual differences among clinicians largely explain variances in outcomes measured. Continued engagement of clinicians least receptive to CPGs may be worthwhile because they are the ones showing most significant gains in CPG quality ratings, endorsement ratings, and intentions to use in practice ratings.

Electronic supplementary materialThe online version of this article doi:10.1186-1748-5908-4-34 contains supplementary material, which is available to authorized users.

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Autor: Melissa Brouwers - Steven Hanna - Mona Abdel-Motagally - Jennifer Yee

Fuente: https://link.springer.com/







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