What do Hong Kong's family physicians think of clinical guidelines? - A questionnaire survey

Abstract

Objective: To study the current use of and attitude towards clinical guidelines (CGs) among Hong Kong's family physicians, and to explore the attributes that may enhance implementation. Design: Postal questionnaire survey. Subjects: A questionnaire was posted to all 1427 members of the Hong Kong College of Family Physicians (HKCFP) in the period from March to July, 2010. Main outcome measures: Response to a questionnaire on the current usage of and attitude towards CGs, respondents' demographic data. Results: 617 completed questionnaires were received (response rate 43.2%). Ninety-one percent of respondents had used CGs in patient care and 85% had used them within a month. Sixty-three percent of respondents gave the internet as the first answer to the question of where they found the clinical guidelines. "Contradicting recommendations" was ranked highest as a barrier to guideline use (82%), followed by "CGs not tailored for individual patient's needs" (77%), and "mistrust guidelines sponsored by pharmaceutical companies" (75%). There was a very high degree of agreement on what constituted a good CG: evidence-based (99%), simple and easy to use (99%), applicable to the local population (99%) and the primary care setting (98%), regularly updated (98%) and with cost effective recommendations (93%). On strategies thought to be useful in promoting the use of CGs, 96% of respondents agreed on effective dissemination, 93% on a central system for adoption of CGs, 90% on involving primary care doctors in drafting CGs and 71% on providing financial incentives. Conclusion: Most respondents were using and supportive of CGs, and would like to have a central system for guideline adoption and effective dissemination. They wished to be more involved in the development process. They thought a good CG should be evidence-based, simple and easy to use and applicable in the local setting. Family physicians' views about CGs are important and relevant for Hong Kong's guideline development policy.