Clinical practice guidelines (CPGs) are systematic statements used to assess appropriateness of health care decisions, services, and outcomes. In 1996, there were >2000 CPGs from >75 organizations. We studied the use and impacts of CPGs for hypertension and depression in a random sample of Massachusetts community-based primary care MDs (N=63 GP/FP, 46 internists). We used semi-structured telephone interviews to assess MDs' awareness of CPGs, positive and negative perceptions, usefulness in clinical practice, and perceptions about conflicts between CPGs. Study MDs tended to be males (77%) with 11-20 years in practice (39%). Respondents split among solo practice (41%), small groups of 2-4 MDs (25%), and larger groups (34%). Most were affiliated with 4-6 managed care organizations. Of 64 MDs interviewed about hypertension CPGs, 72% were aware of CPGs, 52% could name a specific CPG, and 13% perceived conflicts among CPGs. Of 45 MDs who selected depression, 60% were aware of CPGs, 40% could name a specific CPG, and none perceived conflicts. Positive CPG attributes mentioned were: useful treatment algorithms (55%), good teaching tools (50%), affirm current practices (22%), and lead to effective therapy (22%). Negative attributes included: rigidity (36%), complexity of clinical problems (29%), time and information overload (23%), liability (23%), leading to withholding (22%) or providing unnecessary care (12%), and association with formularies (11%). Most MDs (56%) felt the contribution of CPGs to clinical practice "hassle" was small. CPGs are viewed in a generally favorable way by Massachusetts MDs but infrequently used in practice.
Learning Objectives: At the conclusion of this session, the participant (learner) will be able to:
Keywords: Practice Guidelines,
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.