Family physicians/GP and Internist opinions, familiarity and practice behaviour regarding clinical practice guidelines (CPGs) of common medical conditions in Nigeria

Abstract

Background: Few studies exist on physicians' opinions, attitudes, familiarity and practice behaviour regarding clinical practice guidelines in sub-Saharan Africa. Objectives: To determine the opinions, familiarity, and practice behaviour regarding clinical practice guidelines (CPGs) and factors associated with their use among internists and family physicians/GP in Nigeria. Methods: A semi-structured questionnaire regarding guidelines of five common medical conditions: hypertension, diabetes mellitus, tuberculosis, asthma and hepatitis B encountered in everyday medical practice were self-administered by 183 doctors across the country. Results: Over 90% of respondents believed that guidelines were evidence-based, improved management outcomes, and quality of care, nevertheless, 57.4% were against using them in litigations against doctors. The majority (>70%) of the respondents were familiar with the guidelines except that of hepatitis B. Overall, guidelines were used regularly by 45.9%, used in part by 23.5% and 30.6% never used it. Approximately 50% of physicians had immediate accessibility to them at the point of care. The proportions of respondents reporting a change in practice behaviour ranged from 37.7-57.9% depending on the guideline. The factors associated with guideline-related behaviour change were familiarity with its contents, postgraduate educational training, increased helpfulness score, and practiced >5 years. Conclusions: The present study shows that most physicians have favourable opinions and are familiar with these guidelines, however, the proportions reporting changes in their patient management because of the guidelines are not satisfactory. It is important to ensure guidelines accessibility and promotes factors that encourage their implementation in medical practice.

Oral health during pregnancy: an analysis of interprofessional guideline awareness and practice behaviors among prenatal and oral health providers

“…Nonetheless, guideline familiarity was significantly associated with all practice behaviors (assess, advise, refer, share/coordinate) among both provider types, demonstrating the importance of guideline familiarity in influencing clinical practice behaviors. Low familiarity with guidelines has been found in studies across a range of health care providers, in addition to low familiarity specific to the prenatal oral health guidelines among prenatal and oral health providers [ 18 , 25 – 27 ]. For example, in one study, lack of guideline familiarity was a primary barrier to physician adherence [ 25 ], while in another study, physician familiarity with five common clinical guidelines was significantly associated with practice behavior change relating to two of the guidelines [ 27 ].…”

“…Low familiarity with guidelines has been found in studies across a range of health care providers, in addition to low familiarity specific to the prenatal oral health guidelines among prenatal and oral health providers [ 18 , 25 – 27 ]. For example, in one study, lack of guideline familiarity was a primary barrier to physician adherence [ 25 ], while in another study, physician familiarity with five common clinical guidelines was significantly associated with practice behavior change relating to two of the guidelines [ 27 ].…”

Descriptive epidemiology of prevalence of exercise habits among participants with hypertension: The National Health and Nutrition Survey 2013–2018

“…Several studies have reported the prevalence of regular exercise among patients with HTN 11–13 ; however, these studies had small sample sizes and were limited to patients in low‐ and middle‐income countries, including Ethiopia, Iran, and China 11–13 . Moreover, medical resources, healthcare systems, and treatment strategies available in low‐ and middle‐income countries differ from those in high‐income countries 5,9,14–16 . Therefore, exercise habits in patients with HTN may differ among low‐, middle‐, and high‐income countries.…”

“… 11 , 12 , 13 Moreover, medical resources, healthcare systems, and treatment strategies available in low‐ and middle‐income countries differ from those in high‐income countries. 5 , 9 , 14 , 15 , 16 Therefore, exercise habits in patients with HTN may differ among low‐, middle‐, and high‐income countries. Hence, it is crucial to assess the proportion of patients engaging in exercise in each country in order to enhance the approach to exercise therapy in the healthcare system.…”