Guideline use behaviours and needs of primary care practitioners in China: a cross-sectional survey

作者：Linan Zeng, Youping Li, Lingli Zhang, Guanjian Liu, Yang Zhang, Shangwei Zhen, Honghao Li, Xue Song, Yanjun Duan, Jiajie Yu, Xiaodong Wang · 发表于：BMJ Open · 年份：2017 · DOI：10.1136/bmjopen-2016-015379 · 被引用次数：33 · 研究领域：Clinical practice guidelines implementation、Health Policy Implementation Science、Health Promotion and Cardiovascular Prevention

OBJECTIVES: Clinical guidelines have been recognised as an effective way to improve healthcare performance. However, little is known about the uptake and implementation of guidelines by general practitioners in China. The aim of this study was to investigate the guideline use behaviours and needs of practitioners in primary care settings in China. METHODS: We conducted a cross-sectional survey from December 2015 to May 2016 that included practitioners at 268 institutions in 15 provinces in China. Questionnaire development was informed by the execution of a literature review and consultation of experts. On-site surveys were implemented using a paper questionnaire to minimise missing responses. A multivariate logistic regression analysis was performed to identify factors associated with provider knowledge of and attitudes towards clinical guidelines. RESULTS: Of the respondents, 91.7% (1568/1708) were aware of clinical guidelines, but only 11.3% (177/1568) frequently used them. The main mechanism by which primary care practitioners accessed guidelines was public search engines (63.4%; 911/1438), and practitioners seldom reported using biomedical databases. The most frequently identified barriers to guideline use were lack of training (49.9%; 778/1560), lack of access (44.6%; 696/1560) and lack of awareness (38.0%; 592/1560). Less than one-quarter of respondents considered current guidelines 'entirely appropriate' for use in primary care (23.5%; 339/1442). Most participants (96....