Why don't physicians follow clinical practice guidelines?: A framework for improvement

Journal of the American Medical Association

Volumn 282, Issue 15, 1999, Pages 1458-1465

  Cabana, Michael D ^b,c   Rand, Cynthia S ^d   Powe, Neil R ^a   Wu, Albert W ^a   Wilson, Modena H ^a   Abboud, Paul André C ^d   Rubin, Haya R ^a  

^a JOHNS HOPKINS BLOOMBERG SCHOOL OF PUBLIC HEALTH   (United States)

^b UNIVERSITY OF MICHIGAN HEALTH SYSTEM   (United States)

^c Division of Pediatric Otolaryngology   (United States)

^d NONE

Author keywords

[No Author keywords available]

Indexed keywords

AWARENESS; BEHAVIOR; CLINICAL PRACTICE; HEALTH CARE; HEALTH CARE DELIVERY; HEALTH CARE QUALITY; HEALTH SERVICE; MEDICAL PRACTICE; PHYSICIAN; PRACTICE GUIDELINE; PRIORITY JOURNAL; REVIEW;

ATTITUDE OF HEALTH PERSONNEL; DATA COLLECTION; GUIDELINE ADHERENCE; HEALTH KNOWLEDGE, ATTITUDES, PRACTICE; PHYSICIAN'S PRACTICE PATTERNS; PRACTICE GUIDELINES; UNITED STATES;

EID: 0032721879     PISSN: 00987484     EISSN: None     Source Type: Journal    
DOI: 10.1001/jama.282.15.1458     Document Type: Review

References (111)

1. Field MJ, Lohr MJ, eds. Clinical Practice Guidelines: Directions for a New Program. Washington, DC: National Academy Press; 1990.
2. Audet AM, Greenfield S, Field M. Medical practice guidelines: current activities and future directions. Ann Intern Med. 1990;30:709-714.
3. Chassin MR. Practice guidelines: best hope for quality improvement in the 1990s. J Occup Med. 1990; 32:1199-1206.
4. Lomas J, Anderson GM, Domnick-Pierre K, Vayda E, Enkin MW, Hannah WJ. Do practice guidelines guide practice? the effect of a consensus statement on the practice of physicians. N Engl J Med. 1989;321:1306-1311.
5. Kanouse DE, Winkler JD, Kosecoff J, et al. Changing Medical Practice Through Technology Assessment: An Evaluation of the NIH Consensus Development Program. Santa Monica, Calif: RAND; 1989.
6. Woolf SH. Practice guidelines: a new reality in medicine, III: impact on patient care. Arch intern Med. 1993; 153:2646-2655.
7. Hayward RSA. Clinical practice guidelines on trial. CMAJ. 1997;156:1725-1727.
8. Greco PJ, Eisenberg JM. Changing physicians' practices. N Engl J Med. 1993;329:1271-1274.
9. Goldman L. Changing physicians' behavior: the pot and the kettle. N Engl J Med. 1990;322:1524-1525.
10. Davis DA, Taylor-Vaisey A. Translating guidelines into practice: a systematic review of theoretic concepts, practical experience and research evidence in the adoption of clinical practice guidelines. CMAJ. 1997;157:408-416.
11. Grilli R, Apolone C, Marsoni S, Nicolucci A, Zola P, Liberati A. The impact of patient management guidelines on the care of breast, colorectal and ovarian cancer patients in Italy. Med Care. 1991;29:50-63.
12. Wigder HN, Arai DA, Narasimhan K, Cohan S. ACEP chest pain policy: emergency physician awareness. Ann Emerg Med. 1996;27:606-609.
13. Balk SJ, Landesman LY, Spellmann M. Centers for Disease Control and Prevention lead guidelines: do pediatricians know them? J Pediatr. 1997;131:325-327.
14. Domnick-Pierre K, Vayda E, Lomas J, Enkin MW, Hannah WJ, Anderson GM. Obstetrical attitudes and practices before and after the Canadian Consensus Conference Statement on Cesarean Birth. Soc Sci Med. 1991;32:1283-1289.
15. Olesen F, Lauritzen T. Do general practitioners want guidelines? attitudes toward a county-based and a national college-based approach. Scand J Prim Health Care. 1997;15:141-145.
16. Christakis DA, Rivara FP. Pediatricians' awareness of and attitudes about four clinical practice guidelines. Pediatrics. 1998;101:825-830.
17. Mansfield CD. Attitudes and behaviours towards clinical guidelines: the clinicians' perspective. Qual Health Care. 1995;4:350-355.
18. Hiddink GJ, Hautvast JG, van Woerkum CM, Fieren O, van't Hof MA. Nutrition guidance by primary-care physicians: perceived barriers and low involvement. Eur J Clin Nutr. 1995;49:842-851.
19. van der Vort J, Edwards A, Roberts R, Verrier-Jones K. The struggle to diagnose UTI in children under two in primary care. Fam Pract. 1997;14:44-48.
20. Feldman EL, Jaffe A, Galambos N, Robbins A, Kelley RB, Fromm J. Clinical practice guidelines on depressions: awareness, attitudes and current knowledge among family physicians in New York. Arch Fam Med. 1997;7:58-62.
21. Kimura S, Pacala JT. Pressure ulcers in adults: family physicians' knowledge, attitudes, practice preferences, and awareness of AHCPR guidelines. J Fam Pract. 1997;44:361-468.
22. Crain EF, Weiss KB, Fagan MJ. Pediatric asthma care in US emergency departments: current practice in the context of the National Institutes of Health guidelines. Arch Pediatr Adolesc Med. 1995;149:893-901.
23. Freed GL, Bordley WC, Clark SJ, Konrad TR. Family physician acceptance of universal hepatitis B immunization of infants. J Fam Pract. 1993;36:153-157.
24. Stange KC, Kelly R, Chao J, et al. Physician agreement with US Preventive Task Force recommendations. J Fam Pract. 1992;34:409-416.
25. Hill MN, Levine DM, Whelton PK. Awareness, use and impact of the 1984 Joint National Committee Consensus Report on High Blood Pressure. Am J Public Health. 1988;78:1190-1194.
26. Cheng TL, Miller EB, Ottolini M, Brasseux C, Rosenquist G. Tuberculosis testing. Arch Pediatr Adolosc Med. 1996;150:682-685.
27. Flocke SA, Strange KC, Fedriko TL. Dissemination of information about the US Preventive Service Task Force guidelines. Arch Fam Med. 1994;3:1006-1008.
28. Ward JE, Boyages J, Gupta L. Local impact of the NHMRC early breast cancer guidelines: where to go from here? Med J Aust. 1997;167:362-365.
29. Freed GL, Bordley WC, Clark SJ, Konrad TR. Reactions of pediatricians to the new Centers for Disease Control recommendation for universal immunization of infants with hepatitis B vaccine. Pediatrics. 1993;91:699-702.
30. Newton J, Knight D, Wollhead G. General practitioners and clinical guidelines: a survey of knowledge, use and beliefs. Br J Gen Pract. 1996;46:513-517.
31. Schocken DD, Schocken DM. Florida's response to the Physician's National Cholesterol Education Program. J Fla Med Assoc. 1992;79:112-116.
32. Klabunde CN, O'Malley MS, Kaluzny AD. Physicians' reactions to change in recommendations for mammography screening. Am J Prev Med. 1997;13: 432-438.
33. Cochi SL, Fleming DW, Hull HF, Preblud SR, Orenstein WA. Haemophilus influenzae b polysaccharide vaccine: physician acceptance and use of a new vaccine. AJDC. 1986;140:1226-1230.
34. Naylor CD, Hollenberg AA, Ugnat AM, Basinski A. Coronary thrombolysis: clinical guidelines and public policy: results of an Ontario practitioner survey. CMAJ. 1990;142:1069-1076.
35. Johnsson M. Evaluation of the consensus conference program in Sweden. Int J Tech Assess Health Care. 1988;4:89-94.
36. Wolff M, Bower DJ, Marbella AM, Casanova JE. US family physician's experiences with practice guidelines. Fam Med. 1998;30:117-121.
37. Shucker B, Wittes JT, Santanello NC, et al. Change in cholesterol awareness and action: results from national physician and public surveys. Arch Intern Med. 1991;151:666-673.
38. Hudak BB, O'Donnell J, Mazyrka N. Infant sleep position: pediatricians' advice to parents. Pediatrics. 1995;95:55-58.
39. Pearsall FJ, Davidson JA, Asbury AJ. Attitudes to the Association of Anesthetists recommendations for standards of monitoring during anesthesia and recovery. Anesthesia. 1995;50:649-653.
40. Pathman DE, Konrad TR, Freed GL, Freeman VA, Koch GG. The Awareness-to-Adherence Model of the steps to clinical guideline compliance: the case of pediatric vaccine recommendations. Med Care. 1996; 34:873-889.
41. Tunis SR, Hayward RS, Wilson MC, et al. Internists' attitudes about clinical practice guidelines. Ann Intern Med. 1994;120:956-963.
42. Meyers DG, Steinle BT. Awareness on consensus preventive medicine practice guidelines among primary care. Am J Prev Med. 1997;13:45-50.
43. Taylor VM, Taplin SH, Urban N, et al. Community organization to promote breast cancer screening ordering by primary care physicians. J Community Health. 1996;21:277-291.
44. Langkamp D, Langhough R. Primary care physicians' knowledge about diphtheria-tetanus-pertussis immunizations in preterm infants. Pediatrics. 1992; 89:52-55.
45. Weinberger M, Saunders AF, Samsa GP, et al. Breast cancer screening in older women: practices and barriers reported by primary care physicians. J Am Geriatr Soc. 1991;39:22-29.
46. Hardern RD, Hampshaw S. What do accident and emergency medical staff think of practice guidelines? Eur J Emerg Med. 1997;4:68-71.
47. Gemson DH, Elinson J. Cancer screening and prevention: knowledge, attitudes, and practices of New York City physicians. N Y State J Med. 1987;87:643-645.
48. Furguson SC, Lieu TA. Blood lead testing by pediatricians: practice, attitudes and demographics. Am J Public Health. 1997;87:1349-1351.
49. Shamir R, Sahavi I, Abramowich T, et al. Management of acute gastorenteritis in children in Israel. Pediatrics. 1998;101:892-894.
50. Black JS, Sefcik T, Kapoor W. Health promotion and disease prevention in the elderly: comparison of house staff and attending physician attitudes and practices. Arch Intern Med. 1990;150:389-393.
51. Rimer BK, Trock B, Balshem A, Engstrom PF, Rosan J, Lerman C. Breast screening practices among primary physicians: reality and potential. J Am Board Fam Pract. 1990;3:26-34.
52. Roetzheim RG, Fox SA, Leake B. Physician-reported determinants of screening mammography in older women: the impact of physician and practice characteristics. J Am Geriatr Soc. 1995;43:1398-1402.
53. American Cancer Society. Survey of physicians' attitudes and practice in early cancer detection. Cancer. 1985;35:197-213.
54. Freed BL, Bordley WC, Clark SJ, Konrad TR. Universal hepatitis B immunization of infants: reactions of pediatricians and family physicians over time. Pediatrics. 1994;93:747-751
55. Kraus DM, Campbell MM, Marcinak JF. Evaluation of universal hepatitis B immunization practice of Illinois pediatricians. Arch Pediatr Adolesc Med. 1994; 148:936-942.
56. Soltez KS, Price JH, Johnson LW, Tellijohann SK. Family physicians view of the Preventive Services Task Force recommendations regarding nutritional counseling. Arch Fam Med. 1995;4:589-593.
57. Zucker AR, Meadow WL. Pediatric critical care physician's attitudes about guidelines for the use of ribavirin in critically ill children with respiratory syncytial virus pneumonia. Crit Care Med. 1995;23:767-772.
58. Hutchinson BG, Abelson J, Woodward CA, Norman G. Preventive care and barriers to effective prevention: how do family physicians see it. Can Fam Physician. 1996;42:1693-1700.
59. Schaffer SJ, Campbell JR, Szilagyi PG, Weitzman M. Lead screening practice of pediatric residents. Arch Pediatr Adolesc Med. 1998;152:185-189.
60. Jafari HS, Schuchat A, Hilsdon R, Whitney CG, Toomey KE, Wenger JD. Barriers to prevention of perinatal group B streptococcal disease. Pediatr Infect Dis J. 1995;14:662-667.
61. Lorino CO, Green AE, Harris JM. Survey of Alabama physicians' use of mammography, 1989. South Med J. 1990;32:1280-1282.
62. Grol R. National standard setting for quality of care in general practice: attitudes of general practitioners and response to a set of standards. Br J Gen Pract. 1990;40:361-364.
63. Bradley KA, Curry SJ, Koepsell TD. Larson EB. Primary and secondary prevention of alcohol problems: US internist attitudes and practices. J Gen Intern Med. 1995;10:89-92.
64. American Cancer Society. 1989 Survey of physicians' attitudes and practices in early cancer detection. Cancer. 1990;40:77-101.
65. James PA, Cowan TM, Graham RP, Majeroni BA. Family physicians' attitudes about and use of clinical practice guidelines. J Fam Pract. 1997;45:341-347.
66. Siriwardena AN. Clinical guidelines in primary care: a survey of general practitioners' attitudes and behavior. Br J Gen Pract. 1995;45:643-647.
67. Alston RP. Guidelines and cardiac anaesthetists: not in my backyard. Anaesthesia. 1997;52:328-331.
68. Hayward RS, Guyatt GH, Moore KA, McKibbon KA, Carter AO. Canadian physician's attitudes about and preferences regarding clinical practice guidelines. CMAJ. 1997;156:1715-1723.
69. Weingarten S, Stone E, Hayward R, et al. The adoption of preventive care practice guidelines by primary care physicians: do actions match intentions. J Gen Intern Med. 1995;10:138-144.
70. Ferrier BM, Woodward CA, Cohen M, Williams AP. Clinical practice guidelines: new-to-practice family physicians' attitudes. Can Fam Physician. 1996; 42:463-468.
71. Salem-Schatz SR, Bottlieb LK, Karp MA, Feingold L. Attitudes about clinical practice guidelines in a mixed model HMO: the influence of physician and organizational characteristics. HMO Pract. 1997;11:111-117.
72. Gupta L, Ward JE, Hayward RS. Clinical practice guidelines in general practice: a national survey of recall, attitude and impact. Med J Aust. 1997; 166:69-71.
73. Shye D, Betz-Brown J. Primary care HMO clinicians' opinions about clinical practice guidelines. HMO Pract. 1995;9:111-115.
74. Grilli R, Penna A, Zola P, Liberati A. Physicians' view of practice guidelines: a survey of Italian physicians. Soc Sci Med. 1996;43:1283-1287.
75. Knowledge, attitudes, and practices of physicians regarding urinary incontinence in persons aged greater or equal to sixty-five years - Massachusetts and Oklahoma, 1993. MMWR Morb Mortal Wkly Rep. 1995;44:747, 753-754.
76. Bull FCL, Schipper EC, Jamrozik K, Blanksby BA. How can and do Australian doctors promote physical activity? Prev Med. 1997;26:866-873.
77. Glanz K, Tziraki C, Albright CL, Fernandes J. Nutrition assessment and counseling practices: attitudes and interests of primary care physicians. J Gen Intern Med. 1995;10:89-92.
78. Langner NR, Hasselback PD, Dunkley GC, Corber SJ. Attitudes and practices of primary care physicians in the management of elevated serum cholesterol levels. CMAJ. 1989;141:33-38.
79. Main DS, Cohen SJ, DiClemente CC. Measuring physician readiness to change cancer screening: preliminary results. Am J Prev Med. 1995;11:54-58.
80. Solberg LI, Brekke ML, Kottke TE. How important are clinician and nurse attitudes to the delivery of clinical preventive services? J Fam Pract. 1997;44: 451-461.
81. Bradley KA, Curry SJ, Koepsell TD, Larson EB. Primary and secondary prevention of alcohol problems: US internist attitudes and practices. J Gen Intern Med. 1995;10:89-92.
82. Prendergast BD, Andrews NP, Thomas A, Davies L, McCabe M, Penny WJ. Hepatitis B immunization among invasive cardiologists: poor compliance with United Kingdom guidelines. Br Heart J. 1995;74:685-688.
83. Luckmann R, Melville SK. Periodic health examination of adults: a survey of family physicians. J Fam Pract. 1995;40:547-554.
84. Saver BG, TaylorTR, Woods NF, Stevens NG. Physician policies on the use of preventive hormone therapy. Am J Prev Med. 1997;13:358-365.
85. Jackson L, Yuan L. Family physicians managing tuberculosis: qualitative study of overcoming barriers. Can Fam Physician. 1997;43:649-655.
86. MCIlvain HE, Crabtree BF, Gilbert C, Havranek R, Backer EL. Current trends in tobacco prevention and cessation in Nebraska physicians' offices. J Fam Pract. 1997;44:193-202.
87. Freeborn DK, Shye D, Mulloory SP, Eraker S, Romeo J. Primary care physicians' use of lumbar spine imaging tests: effects of guidelines and practice pattern feedback. J Gen Intern Med. 1997;12:619-625.
88. Practice Guidelines: The Experience of Medical Specialty Societies. Washington, DC: US General Accounting Office; 1991.
89. Lomas J. Retailing research: increasing the role of evidence in clinical services for childbirth. Milbank Q. 1993;71:439-475.
90. Stress JK, Harlan WR. The dissemination of new medical information. JAMA. 1979;241:2622-2524.
91. Bandura A. Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice-Hall Inc; 1986.
92. Hyman DJ, Maibach WE, Flora JA, Fortmann SP. Cholesterol treatment practices of primary care physicians. Public Health Rep 1992;107:441-448.
93. United States Preventive Services Task Force. Guide to Clinical Preventive Services. 2nd ed. Alexandra, Va: International Medical Publishing Inc; 1996.
94. Wechsler H, Levine S, Idelson RK, Rohman M, Taylor JO. The physician's role in health promotion: a survey of primary care practitioners. N Engl J Med. 1983; 308:97-100.
95. Anda RF, Remington PL, Sineko DB, Davis RM. Are physicians advising smokers to quit? the patient's perspective. JAMA. 1987;257:1916-1919.
96. Brown ER, Wyn R, Cumberland WB, et al. Women's Health Related Behaviors and Use of Clinical Preventive Services: A Report to the Commonwealth Fund. Los Angeles: University of California, Los Angeles Center for Health Policy Research; 1995.
97. Wells KB, Lewis CE, Leake B, Schleiter MK, Brook R. The practices of general and subspecialty internists in counseling about smoking and exercise. Am J Public Health. 1986;76:1009-1013.
98. Kottke TE, Willms DB, Solberg LI, Brekke ML. Physician-delivered smoking cessation advice: issues identified during ethnographic interviews. Tob Control. 1994;3:46-49.
99. Wilson DM, Taylor DW, Gilbert JR, et al. A randomized trial of family physician intervention for smoking cessation. JAMA. 1988;260:1570-1574.
100. Cummings SR, Rubin SM, Oster G. The cost-effectiveness of counseling smokers to quit. JAMA. 1989;261:75-79.
101. Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol. 1983; 51:390-395.
102. Geertsma RH, Parker RC, Whitbourne SK. How physicians view the process of change in their practice behavior. J Med Educ. 1982;57:752-761.
103. Fox RD, Mazmanian PE, Putnam RW. A theory of learning and change. In: Fox RD, Mazmanian PE, Putnam RW, eds. Changing and Learning in the Lives of Physicians. New York, NY: Praeger; 1989:161-175.
104. Winkler JD, Lohr KN, Brook RH. Persuasive communication and medical technology assessment. Arch Intern Med. 1985;145:314-317.
105. Grilli R, Lomas J. Evaluating the message: the relationship between compliance rate and the subject of a practice guideline. Med Care. 1994;32:202-213.
106. Rogers EM. Diffusion of Innovations. 4th ed. New York, NY: Free Press; 1995.
107. Woo B, Woo B, Cook EF, Weisberg M, Goldman L. Screening procedures in the asymptomatic adult: comparison of physicians' recommendations, patients' desires, published guidelines, and actual practice. JAMA. 1985;254:1480-1484.
108. Resnicow KA, Schorow M, Bloom HG, Massad R. Obstacles to family practitioners use of screening tests: determinants of practice? Prev Med. 1989;18: 101-112.
109. Kosecoff J, Kanouse DE, Rogers WH, McCloskey L. Winslow CM, Brook RH. Effects of the National Institutes of Health Consensus Development Program on physician practice. JAMA. 1987;258: 2709-2713.
110. Begg CB, Berlin JA. Publication bias: a problem in interpreting medical data. J R Stat Soc. 1988;151: 419-463.
111. Gielen AC, McDonald EM. The PRECEED-PROCEED planning model. In: Glanz K, Lewis FM, Rimer BK, eds. Health Behavior and Health Education. 2nd ed. San Francisco, Calif: Josey Bass Inc; 1997.