Usage and demand for clinical practice guidelines among Chinese health practitioners_Chinese Journal of Evidence-Based Medicine

Authors：

HUANG Chao ¹ , DU Liang ² , CHEN Yaolong ³ , WANG Xiaoqin ³ , JIANG Shuai ⁴ , LI Jun ¹ , JIANG Tingde ⁴ , LV Peng ⁵ ,  WANG Qiang ¹

1. National Center for Medical Service Administration, National Health Commission of the People’s Republic of China, Beijing, 100044, P.R.China;
2. Chinese Evidence-based Medicine Center, West China Hospital of Sichuan University, Chengdu, 610041, P.R.China;
3. Evidence-based Medicine Center, Lanzhou University, Lanzhou, 730000, P.R.China;
4. People’s Hospital of Deyang City, Deyang, 618000, P.R.China;
5. Yuhuangding Hospital of Yantai, Medical College of Qingdao University, Yantai, 264000, P.R.China;

Corresponding?author：

WANG Qiang, Email: jason2019@sina.cn

Keywords：

Clinical practice guidelines; Use; Demand; Chinese health practitioners; Questionnaire

DOI：

10.7507/1672-2531.201806054

Video：

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Objectives To investigate Chinese health practitioners’ usage and demand for clinical practice guidelines in general so as to improve the development and implementation of guidelines.Methods We conducted a cross-sectional questionnaire survey that covered health practitioners from different levels of medical institutions in 17 provinces in China. Attitudes, adherence, usage barriers and demands for clinical practice guidelines were investigated.Results A total of 953 health practitioners were involved in the survey in which 931 completed the questionnaires. Respondents generally held positive attitudes toward guidelines and agreed that they improved quality of care and standardized diagnosis and treatment. More than 80% of the respondents reported a fine adherence to guidelines. The most reported barriers to follow the guidelines were " several guidelines are competing” and " lack of facilities and medical resources”. Most respondents agreed that it was necessary to establish a national guideline database, appraise implementation effect of guidelines, develop evaluation tools for guidelines that are applicable for Chinese clinical practice, and provide guidelines training.Conclusions This study finds favorable attitudes and fine adherence towards clinical guidelines in general in China. However, internal barriers, such as authority of guidelines, and external barriers, such as supplying system and patients’ preference, can affect guideline dissemination and implementation. It is suggested that establishing a national guidelines database, developing evaluation tools for guidelines that fit for Chinese clinical practice, and provision of guideline training, would facilitate the use of guidelines.

Citation： HUANG Chao, DU Liang, CHEN Yaolong, WANG Xiaoqin, JIANG Shuai, LI Jun, JIANG Tingde, LV Peng, WANG Qiang. Usage and demand for clinical practice guidelines among Chinese health practitioners. Chinese Journal of Evidence-Based Medicine, 2019, 19(6): 635-638. doi: 10.7507/1672-2531.201806054 Copy

1.	郭燕紅. 推進分級診療, 構建連續健康服務. 中國全科醫學, 2017, 20(1): 1-5.
2.	王敏, 余郭莉, 黃玉梅, 等. 分級診療制度實施障礙及應對策略研究. 衛生經濟研究, 2017, (4): 15-18.
3.	IOM. Clinical practice guidelines we can trust. Washington, DC: The National Academies Press, 2011.
4.	王小欽, 王吉耀. 循證臨床臨床實踐指南的制定和實施. 北京: 人民衛生出版社, 2015: 3-4.
5.	林夏, 楊克虎, 陳耀龍, 等. 中國臨床實踐指南的現狀與思考. 中國循證醫學雜志, 2017, 17(5): 497-500.
6.	Pille T, Marika R, Jarno H, et al. Barriers and facilitators to the implementation of clinical practice guidelines: A cross-sectional survey among physicians in Estonia. BMC Health Serv Res, 2012, 12(1): 455.
7.	Yang J, Han C, Yoon HK, et al. Experiences and barriers to implementation of clinical practice guideline for depression in Korea. BMC Psychiatry, 2013, 13(1): 150.
8.	Birrenbach T, Kraehenmann S, Perrig M, et al. Physicians’ attitudes toward, use of, and perceived barriers to clinical guidelines: a survey among Swiss physicians. Adv Med Educ Pract, 2016, 7: 673-680.
9.	季聰華, 曹毅, 張穎, 等. 12個病種中醫臨床診療指南適用性評價. 中醫雜志, 2015, 56(4): 293-296.
10.	陳耀龍, 姚亮, 王琪, 等. 甘肅省皋蘭縣基層醫務工作者對臨床實踐指南的認知、態度與行為調查. 中國循證醫學雜志, 2014, 14(6): 674-677.
11.	韋丙奇, 張建, 謝苗榮, 等. 內科醫師心力衰竭基本知識掌握情況的調查分析. 中華心血管雜志, 2013, 41(9): 766-770.
12.	Xu XL, Zhou JC, Pan KH, et al. Attitudes toward the American nutrition guidelines for the critically ill patients of Chinese intensive care physicians. Asia Pac J Clin Nutr, 2015, 24(2): 347-358.
13.	史楠楠, 韓學杰, 信富榮, 等. 高血壓病中醫臨床實踐指南使用情況調查研究. 世界科學技術-中醫藥現代化, 2011, 13(4): 731-736.
14.	Jiang J, Hong T, Yu R, et al. Knowledge of secondary prevention guidelines for coronary heart disease: results from a physicians' survey in China. Eur J Prev Cardiol, 2012, 19(5): 991-998.
15.	Wei L, Jia JD, Weng XH, et al. Treating chronic hepatitis B virus: Chinese physicians' awareness of the 2010 guidelines. World J Hepatol, 2016, 8(18): 762-769.
16.	Chen EQ, Wang ML, Bai L, et al. Junior doctors’ knowledge about chronic hepatitis B guideline: a survey among 30 primary hospitals in Sichuan province of China. Hepat Month, 2017, 17(3): e58695.
17.	Carlsen B, Bringedal B. Attitudes to clinical guidelines-do GPs differ from other medical doctors? BMJ Qual Saf, 2011, 20(2): 158-162.
18.	Carlsen B, Bringedal B. Clinical practice guidelines in the intensive care unit: a survey of Canadian clinicians’ attitudes. Can J Anesth, 2007, 54(9): 728-736.
19.	Zeng LN, Li YP, Zhang LL, et al. Guideline use behaviors and needs of primary care practitioners in China: a cross-sectional survey. BMJ Open, 2017, 7(9): e015379.

1. 郭燕紅. 推進分級診療, 構建連續健康服務. 中國全科醫學, 2017, 20(1): 1-5.
2. 王敏, 余郭莉, 黃玉梅, 等. 分級診療制度實施障礙及應對策略研究. 衛生經濟研究, 2017, (4): 15-18.
3. IOM. Clinical practice guidelines we can trust. Washington, DC: The National Academies Press, 2011.
4. 王小欽, 王吉耀. 循證臨床臨床實踐指南的制定和實施. 北京: 人民衛生出版社, 2015: 3-4.
5. 林夏, 楊克虎, 陳耀龍, 等. 中國臨床實踐指南的現狀與思考. 中國循證醫學雜志, 2017, 17(5): 497-500.
6. Pille T, Marika R, Jarno H, et al. Barriers and facilitators to the implementation of clinical practice guidelines: A cross-sectional survey among physicians in Estonia. BMC Health Serv Res, 2012, 12(1): 455.
7. Yang J, Han C, Yoon HK, et al. Experiences and barriers to implementation of clinical practice guideline for depression in Korea. BMC Psychiatry, 2013, 13(1): 150.
8. Birrenbach T, Kraehenmann S, Perrig M, et al. Physicians’ attitudes toward, use of, and perceived barriers to clinical guidelines: a survey among Swiss physicians. Adv Med Educ Pract, 2016, 7: 673-680.
9. 季聰華, 曹毅, 張穎, 等. 12個病種中醫臨床診療指南適用性評價. 中醫雜志, 2015, 56(4): 293-296.
10. 陳耀龍, 姚亮, 王琪, 等. 甘肅省皋蘭縣基層醫務工作者對臨床實踐指南的認知、態度與行為調查. 中國循證醫學雜志, 2014, 14(6): 674-677.
11. 韋丙奇, 張建, 謝苗榮, 等. 內科醫師心力衰竭基本知識掌握情況的調查分析. 中華心血管雜志, 2013, 41(9): 766-770.
12. Xu XL, Zhou JC, Pan KH, et al. Attitudes toward the American nutrition guidelines for the critically ill patients of Chinese intensive care physicians. Asia Pac J Clin Nutr, 2015, 24(2): 347-358.
13. 史楠楠, 韓學杰, 信富榮, 等. 高血壓病中醫臨床實踐指南使用情況調查研究. 世界科學技術-中醫藥現代化, 2011, 13(4): 731-736.
14. Jiang J, Hong T, Yu R, et al. Knowledge of secondary prevention guidelines for coronary heart disease: results from a physicians' survey in China. Eur J Prev Cardiol, 2012, 19(5): 991-998.
15. Wei L, Jia JD, Weng XH, et al. Treating chronic hepatitis B virus: Chinese physicians' awareness of the 2010 guidelines. World J Hepatol, 2016, 8(18): 762-769.
16. Chen EQ, Wang ML, Bai L, et al. Junior doctors’ knowledge about chronic hepatitis B guideline: a survey among 30 primary hospitals in Sichuan province of China. Hepat Month, 2017, 17(3): e58695.
17. Carlsen B, Bringedal B. Attitudes to clinical guidelines-do GPs differ from other medical doctors? BMJ Qual Saf, 2011, 20(2): 158-162.
18. Carlsen B, Bringedal B. Clinical practice guidelines in the intensive care unit: a survey of Canadian clinicians’ attitudes. Can J Anesth, 2007, 54(9): 728-736.
19. Zeng LN, Li YP, Zhang LL, et al. Guideline use behaviors and needs of primary care practitioners in China: a cross-sectional survey. BMJ Open, 2017, 7(9): e015379.

Chinese Journal of Evidence-Based Medicine

Usage and demand for clinical practice guidelines among Chinese health practitioners

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