Use of clinical practice guidelines and factors related to their uptake: a survey of health professionals in Spain.

Journal of evaluation in clinical practice

PubMedID: 24921083

Kotzeva A, Guillamón I, Gracia J, Díaz del Campo P, Gich I, Calderón E, Gaminde I, Louro-González A, Martínez F, Orrego C, Rotaeche R, Salcedo F, Alonso-Coello P, Spanish CPGs Working Group. Use of clinical practice guidelines and factors related to their uptake: a survey of health professionals in Spain. J Eval Clin Pract. 2014;20(3):216-24.
RATIONALE, AIMS AND OBJECTIVE
This study aims to assess the use of clinical practice guidelines (CPGs) among health professionals and factors related to their uptake in clinical practice.

METHODS
Cross-sectional study based on an online survey conducted among primary care (PC) and hospital-based care (HC) doctors in Spain in 2011. Questionnaire development included adaptation of similar surveys and contextualization through a qualitative study. After a pilot study and review, the final survey contained five domains: demographics, involvement in CPGs, consultation of CPGs, perceptions and attitudes regarding CPGs and Spanish NHS CPGs Programme. Professionals from selected health care centres in seven regions were contacted by email with an invitation and link to the Web-based questionnaire. We analysed between-group differences and explored potential predictors of CPGs use by means of a logistic regression.

RESULTS
Six hundred seventy-six doctors responded to the survey (27.7% response rate). 47.1% were PC and 49.5% were HC doctors. 32.5% stated previous involvement in CPGs and 56.5% stated training in research methodology. 67.5% of the surveyed professionals reported using CPGs more than one time per week. The use of a system for classifying the quality of evidence (62.3%) and for grading the strength of the recommendations (58.6%), as well as the use of a rigorous methodology (49.6%), were the most frequently reported aspects related to CPG credibility. The lack of time (56.4%), especially in PC (65.3% versus 49.5% in HC; P?
CONCLUSIONS
Study results suggest that, in general, Spanish doctors trust and use CPGs frequently. To improve uptake by health professionals and to overcome existing barriers, CPGs should be rigorously developed and made accessible at the point-of-care in user-friendly electronic formats. Due to the low response rate, findings should be extrapolated with caution.