A national survey of Chinese medicine doctors and clinical practice guidelines in China

Liu, Mengyu; Zhang, Chi; Zha, Qinglin; Yang, Wei; Yuwen, Ya; Zhong, Linda L. D.; Bian, Zhaoxiang; Han, Xuejie; Lü, Aiping

doi:10.1186/s12906-017-1946-2

Cited by 15 publications

(10 citation statements)

References 15 publications

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“…No systematic data have been published on the implementation of, and adherence to, clinical guidelines in China. Two investigations showed that the adherence rate of clinicians to guidelines for traditional Chinese medicine was 50% 11 and the adherence rate of patients in gout treatment was 20-40%. 12…”

Section: Status Of Clinical Practice Guidelines Developed In Chinamentioning

confidence: 99%

Clinical practice guidelines in China

Chen

Wang

Shang

et al. 2018

BMJ

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Section: Status Of Clinical Practice Guidelines Developed In Chinamentioning

confidence: 99%

Clinical practice guidelines in China

Chen

Wang

Shang

et al. 2018

BMJ

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“…The result is similar to a survey by Mengyu Liu, et al in China. They investigated the views of Chinese medicine (CM) doctors on guidelines in China, and showed that a majority of respondents stated that they were familiar with CPGs, however, signi cantly fewer claimed to be following some form of these [29].…”

Section: Interpretation Of Ndingsmentioning

confidence: 99%

Determinants of successful guideline implementation: A national cross-sectional survey

Jin¹,

Tan

Khan

et al. 2021

Preprint

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Background: CPGs are not uniformly successful in improving care and several instances of implementation failure have been reported. Performing a comprehensive assessment of the barriers and enablers is key to developing an informed implementation strategy. Our objective was to investigate determinants of guideline implementation and explore associations of self-reported adherence to guidelines with characteristics of participants in China.Methods: This is a cross-sectional survey, using multi-stage stratified typical sampling based on China's economic regional divisions (the East, the Middle, the West and the Northeast). 2-5 provinces were selected from each region. 2-3 cities were selected in each province, and secondary and tertiary hospitals from each city were included. We developed a questionnaire underpinned by recommended methods for the design and conduct of self-administered surveys and based on conceptual framework of guideline use, in-depth related literature analysis, guideline development manuals, related behavior change theory. Finally, multivariate analyses were performed using logistic regression to produce adjusted odds ratios (OR) and 95% confidence intervals (95%CI).Results: The questionnaire consisted of four sections: knowledge of methodology for developing guidelines; barriers to accessing guideline; barriers to guideline implementation; and methods for improving guideline implementation. There were 1732 participants (87.3% response rate) from 51 hospitals. Of these, 77.2% reported to have used guidelines frequently or very frequently. The key barriers to guideline use were lack of education or training (46.2%), and overly simplistic wording or overly broad scope of recommendations (43.8%). Level of adherence to guidelines was associated with geographical regions (the northeast P＜0.001; the west P=0.02; the middle P＜0.001 compared with the east), hospital grades(P=0.028), length of practitioners’ practice (P =0.006), education background (PhD, P=0.027; Master, P=0.002), evidence-based medicine skills acquired in work unit (P=0.012), and medical specialty of practitioner (General Practice, P=0.006; Surgery, P=0.043). Conclusion: Despite general acknowledgement of the importance of guidelines, the use of guidelines was not as frequent as might have been expected. To optimize the likelihood of adherence to guidelines, guideline implementation should follow an actively developed dissemination plan incorporating features associated with adherence in our study.

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“…In contrast to our study where guideline use was high, it has been observed that few Chinese medical doctors follow them. The poor knowledge of guideline-related information has also been documented in Chinese primary care [28,29]. Concerns about how the perceived need for high level of resource hinders guideline implementation have been addressed by developing a framework for stratifying guideline recommendations according to health care setting level [26,31].…”

Section: Interpretation Of Ndingsmentioning

confidence: 99%

Determinants of Successful Guideline Implementation: A National Cross-Sectional Survey

Jin¹,

Tan

Khan

et al. 2020

Preprint

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Abstract Background: CPGs are not uniformly successful in improving care and several instances of implementation failure have been reported. Performing a comprehensive assessment of the barriers and enablers is key to developing an informed implementation strategy. To investigate determinants of guideline implementation and explore associations of self-reported adherence to guidelines with characteristics of participants in China.Methods: This is a cross-sectional survey, using multi-stage stratified typical sampling based on China's economic regional divisions (the East, the Middle, the West and the Northeast). 2-5 provinces were selected from each region. 2-3 cities were selected in each province, and secondary and tertiary hospitals from each city were included. We developed a questionnaire underpinned by recommended methods for the design and conduct of self-administered surveys and based on conceptual framework of guideline use, in-depth related literature analysis, guideline development manuals, related behavior change theory. At last, multivariate analyses were performed using logistic regression to produce adjusted odds ratios (OR) and 95% confidence intervals (95%CI).Results: The questionnaire consisted of four sections: knowledge on methodology for developing guidelines; barriers to accessing guideline; barriers to guideline implementation; and methods for improving guideline implementation. There were 1732 participants (87.3% response rate) from 51 hospitals. Of these, 77.2% reported to have used guidelines frequently or very frequently. The key barriers to guideline use were lack of education or training (46.2%), and overly simplistic wording or overly broad scope of recommendations (43.8%). Level of adherence to guidelines was associated with geographical regions (the northeast P＜0.001; the west P=0.02; the middle P＜0.001 compared with the east), hospital grades(P=0.028), length of practitioners’ practice (P =0.006), education background (PhD, P=0.027; Master, P=0.002), evidence-based medicine skills acquired in work unit (P=0.012), and medical specialty of practitioner (General Practice, P=0.006; Surgery, P=0.043). Conclusion: Despite general acknowledgement of the importance of guidelines, the use of guidelines was not as frequent as might have been expected. To optimize the likelihood of adherence to guidelines, guideline implementation should follow an actively developed dissemination plan incorporating features associated with adherence in our study.

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A national survey of Chinese medicine doctors and clinical practice guidelines in China

Cited by 15 publications

References 15 publications

Clinical practice guidelines in China

Clinical practice guidelines in China

Determinants of successful guideline implementation: A national cross-sectional survey

Determinants of Successful Guideline Implementation: A National Cross-Sectional Survey

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