A Study of Barriers and Facilitators of Clinical Practice Guidelines Implementation among Physicians

Abstract

Alnaim and Almazrou.: Barriers and Facilitators of Clinical Practice GuidelinesThere is a gap in understanding the barriers and facilitators related to guideline implementation in Saudi Arabia. A descriptive cross sectional study was conducted to identify the factors that may act as barriers or facilitators of clinical practice guidelines used by physicians working in Riyadh, Saudi Arabia. A survey was distributed to 215 physicians working at universities and government hospitals in Riyadh city. The survey was pilot-tested on a small group of physicians to improve the clarity and limit response bias. A total of 157 physicians completed the questionnaire. About 88.5% of the physicians indicated that they did implement clinical practice guidelines in their practice while 9.6% declared that they did not implement any guidelines. Clinical practice guideline implementation was not affected by the physician role, years of experience or nationality. There were less female physicians that opted for clinical practice guidelines (P<0.5). Eighty four percent of the physicians chose them because they are evidence-based while only 40.1% incorporated them because it was part of their institutions' regulation. There was a weak positive relation between the total scores of barriers and facilitators assessment tool and the nationality of the physician. The reasons for choosing specific guidelines were not determined by the physician role, years of experience, nationality or gender. Most agreed that clinical practice guidelines served as a good foundation for self-study and still provide space for them to come to their own conclusions, but at the same time, they would like to know more about them before they decide to apply it. The implementation of guidelines was obstructed by three barriers, which were lack of support by the leadership, lack of awareness and lack of knowledge. On the other hand, the ease of access and autonomy has driven the implementation of clinical practice guidelines. Nonetheless, the barriers and facilitators experienced by the physicians may differ depending on their ethnicity and gender.

Clinical significance of analysis of the level of blood fat, CRP and hemorheological indicators in the diagnosis of elder coronary heart disease

“…Hemorheology is critical in evaluating the development and progression of diseases. Due to an increase in age, hyperviscosity emerges in response to the aging and decline in organs or tissues, which can induce the anomaly in the vascular morphology and hemorheology in the microenvironment, thus affecting the physiological function (Alnaim and Almaz, 2017, Eseyin et al, 2018, Gao et al, 2017, Godsland et al, 1998, Sorlie et al, 1999, Wang et al, 2018). A great number of experimental and clinical studies have conformed the interaction between the geriatric diseases and hyperviscosity.…”

Perceptions of physicians in Saudi Arabia on the use of international clinical guidelines for managing primary insomnia

“…In addition, 98% had confidence in well-developed guidelines especially for the management of diabetic keto-acidosis [19]. Almazrou and Alnaim (2018), in Riyadh, Saudi Arabia, found that 89% of physicians used clinical guidelines in the management of their patients either because they were based on evidence (84%) or because it was a requirement by the institutions where they work (40%) [21]. The main barriers against the implementation of clinical guidelines in the region were the lack of awareness of the guideline and knowledge of its use and application [21].…”

“…Almazrou and Alnaim (2018), in Riyadh, Saudi Arabia, found that 89% of physicians used clinical guidelines in the management of their patients either because they were based on evidence (84%) or because it was a requirement by the institutions where they work (40%) [21]. The main barriers against the implementation of clinical guidelines in the region were the lack of awareness of the guideline and knowledge of its use and application [21]. Also, a self-administered questionnaire conducted in Riyadh found that 40% of physicians did not consider sleep disorders a distinct specialty [22].…”

Efficient polysaccharides from Crinum asiaticum L.’s structural characterization and anti-tumor effect

“…1 ml of double distilled water to dissolve CAL-n 2 mg purified polysaccharide, formulated as a 2 mg/ml concentration of the polysaccharide solution was analyzed by liquid chromatography under the same conditions, record retention time, to obtain samples of the elution volume polysaccharides (Cetindag et al, 2019, Alnaim and Almaz, 2017), by formula obtained Kav, then Kav polysaccharide sample values into a standard curve obtained l g Mw, finally calculated molecular weight polysaccharide test sample (see Fig. 5).…”