Provider‐perceived barriers and facilitators for ischaemic heart disease (IHD) guideline adherence

Powell‐Cope, Gail; Luther, Stephen L.; Neugaard, Britta; Vara, John; Nelson, Audrey

doi:10.1111/j.1365-2753.2003.00450.x

Cited by 27 publications

(23 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Almost 80% of our pediatricians disagreed or strongly disagreed that CPGs will unlikely lead to improvement of outcome. Clinicians are more likely to adhere to CPGs if they are derived from credible sources or organizations,8,11 if they are perceived as beneficial for patients,12 and if resources are available 13…”

Section: Discussionmentioning

confidence: 99%

Pediatricians’ perceptions of clinical practice guidelines

Hendaus¹,

Alhammadi²,

Razig³

et al. 2014

JMDH

View full text Add to dashboard Cite

BackgroundClinical practice guidelines (CPGs) are propositions for health care providers about the care of patients and are usually described as “systematically developed statements to assist practitioners’ and patients’ decisions about appropriate health care for specific circumstances”.ObjectivesThe purpose of this study was to investigate pediatricians’ perceptions of clinical practice guidelines at Hamad Medical Corporation (HMC) in Qatar.MethodsA cross-sectional study was conducted at HMC between May 1 and August 31, 2013 using a self-administered questionnaire that was distributed to 240 pediatricians.ResultsA total of 169/240 questionnaires were completed for a response rate of 70.4%. Our main finding was that pediatricians at all levels are familiar with CPGs and use them. In addition, our doctors believe that CPGs lead to good quality of care, are practical, provide standardized patient care, will keep them up-to-date, decrease the rate of litigation, are evidence-based, do not restrict continuity of self-education, do not alter physician esteem, lead to improvement of outcome, and are practical. However, barriers that might impede pediatricians’ use of CPGs are that CPGs affect their clinical judgment, do not match with their practice style, and do not reduce health care costs.ConclusionsPediatricians at HMC have positive perceptions of CPGs. The results of our study suggest that CPGs are likely to be implemented if more counseling and education are provided to pediatricians regarding the usefulness of evidence-based guidelines. In addition, a program should be initialized to remove barriers while simultaneously addressing physicians’ concerns.

show abstract

Section: Discussionmentioning

confidence: 99%

Pediatricians’ perceptions of clinical practice guidelines

Hendaus¹,

Alhammadi²,

Razig³

et al. 2014

JMDH

View full text Add to dashboard Cite

show abstract

“…This finding might be related to professionals' experience in using CPGs for stroke and a culture of evidence-based practice. Furthermore, specific criteria, such as whether the source of the guidelines is a credible and respected body or organization, encourage health care providers to use and adhere to certain CPGs 10. As a result, the fact that our CPGs for stroke have been accredited by the Korean Stroke Society, the Korean Neurological Association, and the Korean Society of Cerebrovascular Surgeons might be one of the more significant reasons for their implementation.…”

Section: Discussionmentioning

confidence: 99%

Physicians' Attitudes Toward Guidelines for Stroke: A Survey of Korean Neurologists

Kwon

Choi

et al. 2014

J Stroke

View full text Add to dashboard Cite

Background and PurposeClinical practice guidelines (CPGs) are regarded as an essential guidance tool for practicing physicians. We surveyed physicians in Korea in order to evaluate their attitudes toward the Korean CPGs for stroke.MethodsWe obtained participation agreement for our survey from 27 centers of the 33 most actively contributing to the Korean Stroke Registry. A total of 174 neurologists participated in a questionnaire interview regarding their attitudes toward CPGs for stroke.ResultsOf 174 participating neurologists, 65 (37.4%) were stroke neurologists. The average age was 33.6±7.1 and 49 (28.2%) were female. Most of the respondents held positive attitudes and opinions regarding the use of the guidelines, whereas only a small percentage (14.9%) responded negatively. More than 60% of the physicians in the survey reported adherence to the Korean CPGs in dyslipidemia management for the secondary prevention of stroke.ConclusionsThe positive attitudes and opinions toward the guidelines imply that physicians' attitudes should not be regarded as a potential barrier to the implementation of Korean CPGs for stroke practiced by general physicians.

show abstract

“…For example, the role of adverse drug effects was often discussed in the context of physician fears of causing side effects rather than the specific side effects themselves. 6, 15, 19–20 Other work has focused on the intrinsic characteristics of clinicians and their environment, for example finding that older physicians and clinicians in certain practice settings are less likely to provide guideline-recommended treatments. 14, 21–22 …”

Section: Discussionmentioning

confidence: 99%

A taxonomy of reasons for not prescribing guideline-recommended medications for patients with heart failure

Steinman

Patil

Kamat

et al. 2010

The American Journal of Geriatric Pharmacotherapy

View full text Add to dashboard Cite

Background Heart failure is common and highly morbid in older adults. Performance measurement systems for this condition may work best when they account for the reasons why physicians do not provide guideline-recommended interventions. Objective To develop a conceptual framework for understanding the proximate, patient-centered reasons why physicians do not prescribe ACE inhibitors and beta blockers to patients with heart failure. Design Focus group study using a two-stage design. First, we asked participants to describe reasons for not prescribing ACE inhibitors and beta blockers to patients with heart failure and impaired ejection fraction. Second, we asked groups to develop concept maps that organized these reasons into categories and described the relationships between these categories. Participants Seven focus groups comprising 31 academically-affiliated clinicians of different specialties and levels of training. Participants were recruited via invitations sent to clinicians within each target group. Approach We synthesized each group’s concept maps to develop a consensus scheme for categorizing reasons for non-prescribing. Results We identified two broad themes. First, clinicians hinted at their own attitudinal barriers to prescribing. However, they framed their comments largely around patient-centered reasons for non-prescribing that arose in individual patient encounters. Second, decision-making about heart failure drug therapy often involved a complex and overlapping series of considerations. Five categories of reasons for not prescribing ACE inhibitors and beta blockers emerged: 1) adverse effects of drug therapy, 2) non-adherence to therapeutic and monitoring plan, 3) patient preferences and beliefs, 4) co-management and transitions of care, and 5) prioritization and patient benefit. Conclusions Physician reasons for not prescribing guideline-recommended drugs for heart failure are complex but can be organized into a useful taxonomy. This taxonomy may be helpful for performance measurement and quality improvement programs that seek to understand and account for reasons for physician non-adherence to guidelines.

show abstract

Provider‐perceived barriers and facilitators for ischaemic heart disease (IHD) guideline adherence

Cited by 27 publications

References 60 publications

Pediatricians’ perceptions of clinical practice guidelines

Pediatricians’ perceptions of clinical practice guidelines

Physicians' Attitudes Toward Guidelines for Stroke: A Survey of Korean Neurologists

A taxonomy of reasons for not prescribing guideline-recommended medications for patients with heart failure

Contact Info

Product

Resources

About

Provider‐perceived barriers and facilitators for ischaemic heart disease (IHD) guideline adherence

Cited by 27 publications

References 60 publications

Pediatricians&rsquo; perceptions of clinical practice guidelines

Pediatricians&rsquo; perceptions of clinical practice guidelines

Physicians' Attitudes Toward Guidelines for Stroke: A Survey of Korean Neurologists

A taxonomy of reasons for not prescribing guideline-recommended medications for patients with heart failure

Contact Info

Product

Resources

About

Pediatricians’ perceptions of clinical practice guidelines

Pediatricians’ perceptions of clinical practice guidelines