The attitudes and beliefs of general practitioners towards clinical practice guidelines: a qualitative study in Al Ain, United Arab Emirates

Abstract

BackgroundThe efficacy of implementing practices based on the best evidence is determined by the limitations and preparedness of the structure and processes of the healthcare system as well as healthcare professionals’ (HCP) levels of knowledge and acceptance. Facilitating implementation of such practices also partly depends on HCPs’ attitudes.MethodWe investigate the attitudes and beliefs of four groups of physicians in the United Arab Emirates on clinical practice guidelines (CPGs), with a focus on applying revisions to these CPGs in a different setting than the one in which they were developed, and where no locally developed guidelines exist.ResultsCPGs were the main source of information for revisions. We identified a rising concern in the applicability of the recommendations, which persists due to a lack of locally developed revisions. Other concerns include the pressures of practice management changes and of coping with the rapid development in resources and the growing demand on its use. Some international and government-endorsed CPGs were still accepted as being the best candidates for adoption.ConclusionsThis group welcomes evidence-based practice and is supported by electronic medical records, structured care programmes, and ongoing quality monitoring. Barriers and facilitators of clinical practice guidelines are discussed and thoughts on effective implementation strategies are considered.Electronic supplementary materialThe online version of this article (10.1186/s12930-018-0041-2) contains supplementary material, which is available to authorized users.

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

“…Physicians revealed that their current practices and choices on whether or not to use available international clinical guidelines when treating primary insomnia depended on knowledge of and resistance to guidelines, the presence of barriers limiting their use, and the lack of facilitators to encourage adherence to the stipulated guidelines. Although some of the themes identified in this study are similar to those discussed in previous studies [16–18], no research, to the best of the authors’ knowledge, has identified physicians’ resistance to implementing international guidelines as a principal theme.…”

“…There is little qualitative research in the Middle East about the knowledge, perceptions and attitudes of general practitioners towards clinical practice guidelines (CPGs) that can help to facilitate implementation of good practice. A recent study in the United Arab Emirates, found that practitioners had a positive attitude towards CPGs and welcomed the use of evidence-based practice that is supported by electronic medical records, persistent quality monitoring and structured care programmes [18]. Participants, however, also expressed negative attitudes towards impractical guidelines, inconsistent recommendations among guidelines and the possibility of ‘changing evidence’ [18].…”

Barriers to and Facilitators of Adherence to Clinical Practice Guidelines in the Middle East and North Africa Region: A Systematic Review

“…Table 2 presents the results of the quality assessment of the qualitative studies. The purposive snowballing sampling technique was used in four studies [16][17][18][19], whereas two studies targeted clinicians in specific hospitals [14,15]. Although the cited studies adequately described the selection of participants, no information was provided on the recruitment process, such as the original number invited and those who declined.…”

“…For instance, two studies presented the topic guides as Supplementary Materials [14,19], one adequately described the topic guide content [16], one described the method used to build the topic guide [15], and four discussed the saturation of data [16][17][18][19]. Analysis was conducted using a thematic framework [17][18][19], grounded theory analysis [16], and qualitative content analysis [14], whereas one study did not report the method used for analysis. The main concern regarding the quality of qualitative studies was that although rigorous, data analysis specifically failed to address the role of the researchers and point out potential bias during the formulation of research questions and data collection including sample recruitment and the rationale for deriving themes from the data.…”

Quality appraisal of gestational diabetes mellitus guidelines with AGREE II: a systematic review

“…Based on AGREE II, two expert consensus received low scores, generally between 4 and 57%, and four domains scored less than 50%, especially in the “Editorial Independence” and “Rigor of Development” domains. As a matter of fact, clinical staffs always regard guidelines as valuable and trustworthy, and they are more likely to make decisions in accordance with recommendations based on a systematic review of the evidence [38, 39]. So evidence-based guidelines are essentially needed.…”