Al Sada Dhabya, Husain Yusra Irshad, Al Misbah Zainab
Family Medicine Clinic, NBB Arad Health Center, Ministry of Health, Sanabis, Bahrain.
Family Medicine Clinic, Muharraq Health Center, Ministry of Health, Sanabis, Bahrain.
Oman Med J. 2023 Jul 31;38(4):e527. doi: 10.5001/omj.2023.84. eCollection 2023 Jul.
To assess the adherence to clinical practice guidelines (CPGs) and explore the barriers to their implementation among primary care physicians (PCPs) in Bahrain.
A cross-sectional study was conducted using an online survey among physicians working in 20 randomly selected public sector primary health centers in Bahrain. Private-sector physicians and family medicine residents were excluded. Outcome measures were assessing the extent of adherence to CPGs, describing the results in association with work roles, gender, level of formal training, and years of working experience, and investigating the barriers to adhering to CPGs.
The subjects were 149 PCPs (consultants, specialists, and general practitioners) working in government primary health centers. The vast majority (98.0%) reported that they implemented CPGs in their daily practice. The most commonly cited reason (79.2%) for implementation was that the CPGs were evidence-based. The most implemented guidelines pertained to diabetes (91.3%), hypertension (81.2%), and hyperlipidemia (69.8%). The least implemented ones were screening of women (38.9%) and postnatal care (45.6%). The level of formal medical training was associated with the implementation of CPGs on preventive care, antenatal and postnatal care, and children and women screening ( < 0.05). Hypertension and bronchial asthma guidelines were implemented more by male physicians ( < 0.05) while female physicians were more adherent to CPGs on antenatal and postnatal care, and women and child screening ( < 0.05). The main barrier reported by the physicians was that they wished to know more about CPGs before applying them (mean ± SD = 3.8 ± 0.9). The perception that managers or directors are non-cooperative towards the application of CPGs was associated with years of experience ( 0.008) and the position of the physician ( 0.028). General practitioners were more likely to consider non-cooperation from patients as a barrier ( 0.025).
Most PCPs in Bahrain are adherent to CPGs in their daily practice and encounter minimal barriers. Identifying and resolving barriers can help develop unified and standardized guidelines that promote better consistency in patient management, minimize medical errors, and conserve resources.
评估巴林初级保健医生（PCP）对临床实践指南（CPG）的遵循情况，并探讨其实施过程中的障碍。
采用横断面研究方法，对巴林20个随机选取的公共部门初级卫生中心工作的医生进行在线调查。排除私营部门医生和家庭医学住院医师。结果指标包括评估对CPG的遵循程度，描述与工作角色、性别、正规培训水平和工作年限相关的结果，以及调查遵循CPG的障碍。
研究对象为149名在政府初级卫生中心工作的PCP（顾问医生、专科医生和全科医生）。绝大多数（98.0%）报告称他们在日常实践中实施了CPG。实施CPG最常见的原因（79.2%）是CPG基于证据。实施最多的指南涉及糖尿病（91.3%）、高血压（81.2%）和高脂血症（69.8%）。实施最少的是妇女筛查（38.9%）和产后护理（45.6%）。正规医学培训水平与预防保健、产前和产后护理以及儿童和妇女筛查方面CPG的实施相关（<0.05）。男性医生对高血压和支气管哮喘指南的实施更多（<0.05），而女性医生在产前和产后护理以及妇女和儿童筛查方面更遵循CPG（<0.05）。医生报告的主要障碍是他们希望在应用CPG之前了解更多相关信息（均值±标准差=3.8±0.9）。认为管理人员或主任对CPG应用不合作的看法与工作年限（0.008）和医生职位（0.028）相关。全科医生更有可能将患者不合作视为障碍（0.025）。
巴林大多数PCP在日常实践中遵循CPG，且遇到的障碍极少。识别和解决障碍有助于制定统一和标准化的指南，促进患者管理的更好一致性，减少医疗差错，并节省资源。
