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German ambulatory care physicians' perspectives on clinical guidelines – a national survey

BACKGROUND: There has been little systematic research about the extent to which German physicians accept or reject the concept and practice of a) clinical practice guidelines (CPG) and b) evidence based medicine (EBM) The aim of this study was to investigate German office-based physicians' pers...

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Autores principales: Butzlaff, Martin, Kempkens, Daniela, Schnee, Melanie, Dieterle, Wilfried E, Böcken, Jan, Rieger, Monika A
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2006
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1550714/
https://www.ncbi.nlm.nih.gov/pubmed/16857051
http://dx.doi.org/10.1186/1471-2296-7-47
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author Butzlaff, Martin
Kempkens, Daniela
Schnee, Melanie
Dieterle, Wilfried E
Böcken, Jan
Rieger, Monika A
author_facet Butzlaff, Martin
Kempkens, Daniela
Schnee, Melanie
Dieterle, Wilfried E
Böcken, Jan
Rieger, Monika A
author_sort Butzlaff, Martin
collection PubMed
description BACKGROUND: There has been little systematic research about the extent to which German physicians accept or reject the concept and practice of a) clinical practice guidelines (CPG) and b) evidence based medicine (EBM) The aim of this study was to investigate German office-based physicians' perspective on CPGs and EBM and their application in medical practice. METHODS: Structured national telephone survey of ambulatory care physicians, four thematic blocks with 21 questions (5 point Likert scale). 511 office-based general practitioners and specialists. Main outcome measures were the application of Clinical Practice Guidelines in daily practice, preference for sources of guidelines and degree of knowledge and acceptance of EBM. In the data analysis Pearson's correlation coefficient was used for explorative analysis of correlations. The comparison of groups was performed by Student's t-test. Chi(2 )test was used to investigate distribution of two or more categorical variables. RESULTS: Of the total study population 55.3% of physicians reported already using guidelines in the treatment of patients. Physicians in group practices (GrP) as well as general practitioners (GP) agreed significantly more with the usefulness of guidelines as a basis for patient care than doctors in single practices (SP) or specialists (S) (Student's t-test mean GP 2.57, S 2.84, p < 0.01; mean GrP 2.55, SP 2.80, p < 0.05). 33.1% of the participants demonstrated a strong rejection to the application of guidelines in patient care. Acceptance of guidelines from a governmental institution was substantially lower than from physician networks or medical societies (36.2% vs. 53.4% vs. 62.0%). 73.8% of doctors interpret EBM as a combination of scientific research and individual medical knowledge; 80% regard EBM as the best basis for patient care. CONCLUSION: Despite a majority of physicians accepting and applying CPGs a large group remains that is critical and opposed to the utilization of CPGs in daily practice and to the concept of EBM in general. Doctors in single practice and specialists appear to be more critical than physicians in group practices and GPs. Future research is needed to evaluate the willingness to acquire necessary knowledge and skills for the promotion and routine application of CPGs.
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spelling pubmed-15507142006-08-19 German ambulatory care physicians' perspectives on clinical guidelines – a national survey Butzlaff, Martin Kempkens, Daniela Schnee, Melanie Dieterle, Wilfried E Böcken, Jan Rieger, Monika A BMC Fam Pract Research Article BACKGROUND: There has been little systematic research about the extent to which German physicians accept or reject the concept and practice of a) clinical practice guidelines (CPG) and b) evidence based medicine (EBM) The aim of this study was to investigate German office-based physicians' perspective on CPGs and EBM and their application in medical practice. METHODS: Structured national telephone survey of ambulatory care physicians, four thematic blocks with 21 questions (5 point Likert scale). 511 office-based general practitioners and specialists. Main outcome measures were the application of Clinical Practice Guidelines in daily practice, preference for sources of guidelines and degree of knowledge and acceptance of EBM. In the data analysis Pearson's correlation coefficient was used for explorative analysis of correlations. The comparison of groups was performed by Student's t-test. Chi(2 )test was used to investigate distribution of two or more categorical variables. RESULTS: Of the total study population 55.3% of physicians reported already using guidelines in the treatment of patients. Physicians in group practices (GrP) as well as general practitioners (GP) agreed significantly more with the usefulness of guidelines as a basis for patient care than doctors in single practices (SP) or specialists (S) (Student's t-test mean GP 2.57, S 2.84, p < 0.01; mean GrP 2.55, SP 2.80, p < 0.05). 33.1% of the participants demonstrated a strong rejection to the application of guidelines in patient care. Acceptance of guidelines from a governmental institution was substantially lower than from physician networks or medical societies (36.2% vs. 53.4% vs. 62.0%). 73.8% of doctors interpret EBM as a combination of scientific research and individual medical knowledge; 80% regard EBM as the best basis for patient care. CONCLUSION: Despite a majority of physicians accepting and applying CPGs a large group remains that is critical and opposed to the utilization of CPGs in daily practice and to the concept of EBM in general. Doctors in single practice and specialists appear to be more critical than physicians in group practices and GPs. Future research is needed to evaluate the willingness to acquire necessary knowledge and skills for the promotion and routine application of CPGs. BioMed Central 2006-07-20 /pmc/articles/PMC1550714/ /pubmed/16857051 http://dx.doi.org/10.1186/1471-2296-7-47 Text en Copyright © 2006 Butzlaff et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Butzlaff, Martin
Kempkens, Daniela
Schnee, Melanie
Dieterle, Wilfried E
Böcken, Jan
Rieger, Monika A
German ambulatory care physicians' perspectives on clinical guidelines – a national survey
title German ambulatory care physicians' perspectives on clinical guidelines – a national survey
title_full German ambulatory care physicians' perspectives on clinical guidelines – a national survey
title_fullStr German ambulatory care physicians' perspectives on clinical guidelines – a national survey
title_full_unstemmed German ambulatory care physicians' perspectives on clinical guidelines – a national survey
title_short German ambulatory care physicians' perspectives on clinical guidelines – a national survey
title_sort german ambulatory care physicians' perspectives on clinical guidelines – a national survey
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1550714/
https://www.ncbi.nlm.nih.gov/pubmed/16857051
http://dx.doi.org/10.1186/1471-2296-7-47
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