Clinical guidelines in primary care: a survey of general practitioners' attitudes and behaviour

Siriwardena, Niro (1995) Clinical guidelines in primary care: a survey of general practitioners' attitudes and behaviour. British Journal of General Practice, 45 (401). pp. 643-647. ISSN 0960-1643

Documents
Clinical guidelines in primary care: a survey of general practitioners' attitudes and behaviour
[img]
[Download]
Request a copy
[img] PDF
Siriwardena_Clinical_guidelines_in_primary_care_BJGP_1995.pdf - Whole Document
Restricted to Repository staff only until 2099.
Available under License Creative Commons Attribution Non-commercial No Derivatives.

1MB

Full text URL: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC123946...

Abstract

Background. In the United Kingdom little is known about general practitioners' attitudes to and behaviour concerning clinical guidelines.
Aim. A study was performed to investigate these two under-researched areas.
Method. In 1994 a postal questionnaire on clinical guidelines was sent to all 326 general practitioner principals on the list of Lincolnshire Family Health Services Authority.
The questionnaire consisted of 20 attitude statements and an open question on clinical guidelines, as well as surveying characteristics and behaviour of respondents.
Results. Of the 326 general practitioners sent questionnaires, 213 (65%) replied. Most respondents (78%) reported having been involved in writing inhouse guidelines. An even greater proportion (92%) reported having participated in clinical audit. Respondents were generally in favour of clinical guidelines, with mean response scores indicating a positive attitude to guidelines in 15 of the 20 statements, a negative attitude in four and equivocation in one. The majority of respondents felt that guidelines were effective in improving patient care (69%). Members (or fellows) of the Royal College of General Practitioners had a more positive attitude than non-members towards guidelines. They were also significantly more likely than non-members to have written inhouse guidelines, as were those who had participated in audit compared with those who had not participated in audit. A substantial minority (over a quarter) of general practitioners were concerned that guidelines may be used for setting performance-related pay, or that they may lead to 'cookbook' medicine, reduce clinical freedom or stifle innovation. There was also concern that guidelines should be scientifically valid.
Conclusion. This study suggests that many general practitioners in the Lincolnshire Family Health Services Authority area have produced written inhouse guidelines. This is largely sustained by positive attitudes about the effectiveness and benefits of clinical guidelines. The positive attitude of RCGP members supports it in its continuing role in developing, implementing and evaluating guidelines in primary care. The question of whether incorporation of guidelines into clinical audit is an effective means to disseminate systematic research-based guidelines warrants further study.

Item Type:Article
Additional Information:Background. In the United Kingdom little is known about general practitioners' attitudes to and behaviour concerning clinical guidelines. Aim. A study was performed to investigate these two under-researched areas. Method. In 1994 a postal questionnaire on clinical guidelines was sent to all 326 general practitioner principals on the list of Lincolnshire Family Health Services Authority. The questionnaire consisted of 20 attitude statements and an open question on clinical guidelines, as well as surveying characteristics and behaviour of respondents. Results. Of the 326 general practitioners sent questionnaires, 213 (65%) replied. Most respondents (78%) reported having been involved in writing inhouse guidelines. An even greater proportion (92%) reported having participated in clinical audit. Respondents were generally in favour of clinical guidelines, with mean response scores indicating a positive attitude to guidelines in 15 of the 20 statements, a negative attitude in four and equivocation in one. The majority of respondents felt that guidelines were effective in improving patient care (69%). Members (or fellows) of the Royal College of General Practitioners had a more positive attitude than non-members towards guidelines. They were also significantly more likely than non-members to have written inhouse guidelines, as were those who had participated in audit compared with those who had not participated in audit. A substantial minority (over a quarter) of general practitioners were concerned that guidelines may be used for setting performance-related pay, or that they may lead to 'cookbook' medicine, reduce clinical freedom or stifle innovation. There was also concern that guidelines should be scientifically valid. Conclusion. This study suggests that many general practitioners in the Lincolnshire Family Health Services Authority area have produced written inhouse guidelines. This is largely sustained by positive attitudes about the effectiveness and benefits of clinical guidelines. The positive attitude of RCGP members supports it in its continuing role in developing, implementing and evaluating guidelines in primary care. The question of whether incorporation of guidelines into clinical audit is an effective means to disseminate systematic research-based guidelines warrants further study.
Keywords:general practice, guidelines, attitudes, behaviour, family practice, informal protocols, management of disease, quality of patient care, doctors' attitudes
Subjects:A Medicine and Dentistry > A300 Clinical Medicine
Divisions:College of Social Science > School of Health & Social Care
ID Code:2599
Deposited By: Niro Siriwardena
Deposited On:30 May 2010 08:18
Last Modified:13 Mar 2013 08:38

Repository Staff Only: item control page