['To read' does not imply 'to act upon': indicators of the acceptance of general practice guidelines. Results of a survey among quality circles of general practitioner centred care (Hausarztzentrierte Versorgung; HZV)].

CONTEXT

Successful guideline implementation requires that the authors get feedback from target groups on the general acceptance of a guideline and the barriers to its implementation. The Guideline Group of General Practitioners (GPs) in Hesse continually surveyed participants of quality circles on pharmacotherapy who discussed these GP specific guidelines together with an analysis of their prescription behaviour.

MATERIAL AND METHODS

Written survey of six general practice guidelines conducted among the members of quality circles in Hesse during 2006 and 2007. The response rate ranged from 69% (n=268; guideline on 'GP Communication Skills') and 80% (n=374; Guideline on 'Chronic Heart Failure'). The questionnaire focused on both general acceptance and the relevance and practicability of individual recommendations.

RESULTS

With pharmacotherapeutic guidelines, between 75% (guideline for dyslipidaemia) and 86% (guideline for stable angina) would be recommended by the respondent GPs to colleagues. High practice relevance was attributed to the communication skills guideline by 70% of the GPs, but only about 50% would recommend it. Three quarters of the GP rated 18 out of 22 selected recommendations as being relevant to therapeutic quality assurance, and 11 of these recommendations as being practicable. Non-medical procedures requiring communication resources and time input as well as motivated patients were more often assessed as being more difficult to implement.

DISCUSSION AND CONCLUSION

A written survey is a suitable tool for gaining insight into the acceptance of diagnostic and therapeutic strategies and for investigating reasons for the refusal of or the barriers to implementation. Recommendations that are poorly accepted and less likely to be implemented as well as possible barriers should be discussed within the guideline group and during circle sessions in order to modify the recommendation and/or develop aids to assist with its transfer into everyday practice.