Wolfe Robert M, Sharp Lisa K, Wang Ralph M
Department of Family Medicine, Northwestern University, The Feinberg School of Medicine, Chicago, Illinois 60611-3078, USA.
J Am Board Fam Pract. 2004 Mar-Apr;17(2):150-7. doi: 10.3122/jabfm.17.2.150.
Clinical practice guidelines (CPGs) have been promoted as a strategy to measure and improve the quality of patient care. However, more effort has been expended on creating guidelines than implementing them. We surveyed family physicians about their knowledge of and attitudes toward 3 well-publicized CPGs.
A survey questionnaire was sent to a national sample of 600 family physicians selected at random from a file from the American Academy of Family Physicians (AAFP).
After 2 mailings, the response rate was 71%. For each of the 3 guidelines, roughly 60% of respondents were familiar or somewhat familiar with the CPG. More than half of family physicians studied said they have changed their medical practices based on CPGs, and only 3% said they do not believe in guidelines and would not use them. Use of CPGs was lowest among physicians in solo practice and among those working in rural areas. However, no significant differences in CPG use or familiarity were noted based on number of years in practice. Many respondents indicated an interest in keeping CPGs current via the internet.
Most American family physicians find CPGs to be helpful, and familiarity with them is fairly uniform across most subgroups studied.
临床实践指南（CPGs）已被推广为一种衡量和提高患者护理质量的策略。然而，在制定指南方面投入的精力比实施指南更多。我们就3个广为人知的临床实践指南，对家庭医生进行了有关其知晓程度和态度的调查。
向从美国家庭医生学会（AAFP）档案中随机抽取的600名家庭医生全国样本发送调查问卷。
经过两次邮寄，回复率为71%。对于这3项指南中的每一项，大约60%的受访者对临床实践指南熟悉或略知一二。超过半数接受调查的家庭医生表示，他们已根据临床实践指南改变了医疗行为，只有3%的人表示不相信指南且不会使用指南。个体执业医生以及在农村地区工作的医生中临床实践指南的使用率最低。然而，根据执业年限，在临床实践指南的使用或知晓程度方面未发现显著差异。许多受访者表示有兴趣通过互联网使临床实践指南与时俱进。
大多数美国家庭医生认为临床实践指南有帮助，并且在大多数研究的亚组中对其知晓程度相当一致。
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