Are GPs Using Clinical Practice Guidelines?

Objective: The aim of this study was to investigate aspects of general practitioners' current use of clinical practice guidelines (CPGs) in daily general practice.

Design: Face to face, semistructured interviews.

Setting: General practices in rural and metropolitan Australia.

Participants: 25 GPs.

Main Outcome Measures: General practitioners' knowledge about CPGs; their recent use and reasons for using them; how GPs used them; where they stored them and which attributes of CPGs they considered to be most, and least, useful.

Results: Each GP interviewed was able to name at least one 'guideline' that they knew about. The most commonly used was a therapeutic guideline with 'prescribing' being the most common reason for accessing a guideline. Most GPs stored guidelines in their consulting room, reading them when they felt they needed to; some also used them during the consultation and showed them to patients. General practitioners used CPGs to assist in making therapeutic decisions more frequently than when deciding when and whether to implement preventive measures.

Conclusions: The main finding from this study is that GPs are not in the main following, or accessing, the CPGs that have been developed. Strategies are required to create a culture in which evidence based guidelines are used and valued within general practice. Such a culture in which the processes of development, dissemination, implementation and evaluation of CPGs are well established, may take 5-10 years to achieve.