Implications Now, the quantity of CPGS of acupuncture is very small. As the quality of the guidelines of acupuncture was low, they were still lots of limitations. The research in methodology of the CPGS of acupuncture still must be enhanced. Background Since 1998, several evidence-based guidelines for Preventive Child Health Care (PCHC) were developed at request of the Dutch Ministry of Ministry of Health Welfare and Sports. The Dutch Centre for Child Health oversees the development, implementation and evaluation of guidelines. Adherence to guidelines is a prerequisite for clients to receive the intended care and benefit. Objective To assess the extent to which professionals in PCHC adhere to key recommendations of nine PCHC-guidelines. Methods We undertook a survey among a representative sample of PCHC-professionals (n = 472). Guideline developers selected key activities/recommendations in their guideline. Participants indicated, for each key activity, the proportion of children they applied the activity to. From this, we calculated the proportion of all prescribed key activities the professionals had actually adhered to (i.e. completeness of use). Participants marked obstructers to adhere to the guidelines. Results 299 (63%) professionals filled-out the questionnaire; 91 doctors, 159 nurses, and 49 medical assistants. Completeness of use varied from 28% to 98% per key activity. Lack of time and lack of client cooperation were often mentioned as obstructers. Discussion There is room for improvement. Problems in measuring adherence have arisen when key recommendations were not very specific. Implications for Guideline Developers/Users To enable future monitoring, guideline developers should be specific in formulating key activities, and make sure that, in the guideline, key activities are clearly recognisable. Assessment of adherence is recommended as a way to point out weaknesses in guidelines and their implementation. P097 ADHERENCE TO GUIDELINES FOR PREVENTIVE CHILD HEALTH CARE IN THE NETHERLANDS
review of clinical guideline implementability. Two analysts independently evaluated each PEM to determine how design principles were applied. Results Though the sample consisted of PEMs designed and developed to influence care, no single PEM scored well across all categories. Some PEMs failed to differentiate major recommendations and did not present them in a stepwise fashion. Most used clear and easy to read text, but highlighting was often inappropriate. Some algorithms lacked logic and consistency. Images were poorly designed and used, which may distract and confuse the reader. Discussion Design principles are not consistently applied in the development of PEMs and improvements are needed to images, presentation of recommendations, and usability of algorithms. Improvements to the design of PEMs may influence their uptake by combating information overload and increasing their perceived ease of use and perceived usefulness. Implications for Guideline Developers/Users Those who create guidelines and other PEMs consider some design principles, but do not implement them consistently. Our checklist can assist guideline developers in employing a range of design principles. Background The use of the recommendation of clinical practice guidelines (CPGs) by health professionals, depends on the diffusion process and local strategies of implementation of a particular guide in a specific service of the institution. Objectives Assess the adherence to the recommendations of CPGs by health professionals internationally. Methods A systematic review of the literature in PubMed was conducted (MeSH term 'Guideline Adherence', filters: published in the last 5 years, meta-analysis). Results Out of 33 documents that were obtained, seven were selected, one systematic review and one document in google academic (Mexico). The percentage of adherence differs markedly depending on the directory in question and on the professionals involved from 61.1 to 72.2%. The median adherence was 45%. The professionals with the greatest adherence were dentists, whereas cardiologists and surgeons did not change their behaviour due to the recommendations of a CPG. Discussion The degree of adherence to the recommendations of the CPG is influenced by different factors, related to the efforts of professional associations, the management of health care organisations, the professionals themselves involved in the care of the patient and the patient himself. Implications for Guideline Developers/Users The key elements for adherence to the recommendations of the CPG are: involvement of the professionals with the strategy, occupational type, and suggested recommendations.
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