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Clinicians' evaluations of, endorsements of, and intentions to use practice guidelines change over time: a retrospective analysis from an organized guideline program

Overview
Title:
Clinicians' evaluations of, endorsements of, and intentions to use practice guidelines change over time: a retrospective analysis from an organized guideline program
Authors:
Brouwers M, Hanna S, Abdel-Motagally M, Yee J
Journal:
Implement Sci
Publication date:
2009
Volume:
4
First page:
34
ISSN:
1748-5908
Link to pubmed:
http://www.ncbi.nlm.nih.gov/pubmed/19558716?dopt=Citation
Link to full text:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2715368/?tool=pubmed
Publication type:
Journal
Abstract
Purpose Clinical practice guidelines (CPGs) can improve clinical care but uptake and application are inconsistent. Objectives were: to examine temporal trends in clinicians’ evaluations of, endorsements of, and intentions to use cancer CPGs developed by an established CPG program; and to evaluate how predictor variables (clinician characteristics, beliefs, and attitudes) are associated with these trends. Design and methods Between 1999 and 2005, 756 clinicians evaluated 84 Cancer Care Ontario CPGs, yielding 4,091 surveys that targeted four CPG quality domains (rigour, applicability, acceptability, and comparative value), clinicians’ endorsement levels, and clinicians’ intentions to use CPGs in practice. Results Time: In contrast to the applicability and intention to use in practice scores, there were small but statistically significant annual net gains in ratings for rigour, acceptability, comparative value, and CPG endorsement measures (p < 0.05 for all rating categories). Predictors: In 17 comparisons, ratings were significantly higher among clinicians having the most favourable beliefs and most positive attitudes and lowest for those having the least favourable beliefs and most negative attitudes (p < 0.05). Interactions Time × Predictors: Over time, differences in outcomes among clinicians decreased due to positive net gains in scores by clinicians whose beliefs and attitudes were least favorable. Conclusion Individual differences among clinicians largely explain variances in outcomes measured. Continued engagement of clinicians least receptive to CPGs may be worthwhile because they are the ones showing most significant gains in CPG quality ratings, endorsement ratings, and intentions to use in practice ratings.
Preview

Clinicians' evaluations of, endorsements of, and intentions to use practice guidelines change over time: a retrospective analysis from an organized guideline program Brouwers M, Hanna S, Abdel-Motagally M, Yee J. Implement Sci 2009; 4:34.

Page last updated: Nov 30, 2009
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