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Barriers to implementing evidence-based clinical guidelines: a survey of early adopters
Heiko Spallek1, Mei Song, Deborah E Polk
1Center for Dental Informatics, Department of Dental Public Health and Information Management, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA. hspallek@pitt.edu
Objective:
The purpose of this study was to identify barriers that early-adopting dentists perceive as common and challenging when implementing recommendations from evidence-based (EB) clinical guidelines.
Method:
This is a cross-sectional study. Dentists who attended the 2008 Evidence-based Dentistry Champion Conference were eligible for inclusion. Forty-three dentists (34%) responded to a 22-item questionnaire administered online. Two investigators independently coded and categorized responses to open-ended items. Descriptive statistics were computed to assess the frequency of barriers and perceived challenges.
Results:
The most common barriers to implementation were difficulty in changing current practice model, resistance and criticism from colleagues, and lack of trust in evidence or research. Barriers perceived as serious problems had to do with lack of up-to-date evidence, lack of clear answers to clinical questions, and contradictory information in the scientific literature.
Conclusions:
Knowledge of barriers will help improve translation of biomedical research for dentists. Information in guidelines needs to be current, clear, and simplified for use at chairside; dentists' fears need to be addressed.
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