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Physician knowledge, attitudes and practices regarding a widely implemented guideline
Marcia M Ward1, Thomas E Vaughn, Tanya Uden-Holman
1Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City 52242-1008, USA.
Journal of Evaluation in Clinical Practice
|August 16, 2002
Summary
Physician adherence to smoking cessation guidelines was assessed. Despite low guideline familiarity, physicians reported practices aligned with guideline recommendations, highlighting opportunities to improve adoption.
Area of Science:
- Medical Practice
- Health Services Research
- Clinical Guidelines
Background:
- Physician adoption of clinical practice guidelines is crucial but often lacking.
- The knowledge-attitude-behaviour model informs practice change.
- The Agency for Health Care Policy and Research (AHCPR) smoking cessation guideline is widely implemented.
Purpose of the Study:
- To evaluate physician knowledge, attitudes, and compliance with the AHCPR smoking cessation guideline.
- To identify barriers and opportunities for guideline implementation.
Main Methods:
- A survey was administered to a random sample of physicians at 128 Veterans Health Administration facilities.
- The survey assessed familiarity, agreement, compliance, and perceived effectiveness of the guideline.
Main Results:
- A 50.3% response rate (879 physicians) was achieved.
- Many physicians reported low familiarity with the guideline (44%) and uncertainty about agreement (42%), compliance (40%), and effectiveness (46%).
- High percentages of physicians reported always/usually explaining smoking risks (86%) and suggesting cessation (94%).
Conclusions:
- Physician practice patterns align with the smoking cessation guideline despite limited guideline familiarity.
- Knowledge is one of many barriers to guideline adherence.
- Healthcare organizations can enhance physician adoption of clinical practice guidelines.