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Clinical practice guidelines' development and use in New Zealand: an evolving process.
Eileen McKinlay1, Deborah McLeod, Antony Dowell
1Department of General Practice, Wellington School of Medicine and Health Sciences, Otago University, Wellington, New Zealand. emckinlay@wnmeds.ac.nz
The New Zealand Medical Journal
|October 12, 2004
Summary
New Zealand general practitioners (GPs) did not regularly use evidence-based guidelines due to usability and relevance issues. Strategies were developed to address these barriers, improving guideline implementation in primary care.
Area of Science:
- Primary Care Research
- Health Services Research
- Evidence-Based Practice
Background:
- General practitioners (GPs) in New Zealand reported low uptake of evidence-based guidelines in clinical decision-making.
- Barriers to guideline use included format, relevance, accessibility, and lack of GP involvement in development.
Purpose of the Study:
- To explore the use of evidence-based guidelines by New Zealand GPs.
- To identify barriers to guideline implementation.
- To develop strategies to overcome these barriers.
Main Methods:
- Semi-structured interviews with New Zealand GPs and policy stakeholders.
- Inductive thematic analysis of interview data.
- Collaborative development of strategies with the New Zealand Guidelines Group (NZGG).
Main Results:
- GPs found guideline formats often unusable and recommendations irrelevant or inaccessible.
- Lack of GP involvement in guideline development and prioritization was a significant barrier.
- Policy stakeholders generally accepted guidelines, but interfaces with the NZGG were minimal.
Conclusions:
- Effective guideline implementation necessitates understanding GP perspectives and attitudes.
- Passive dissemination and policy endorsement are insufficient for successful guideline use.
- Active strategies addressing GP-identified barriers are crucial for improving guideline adoption.