Guideline use behaviours and needs of primary care practitioners in China: a cross-sectional survey.
OBJECTIVES
Clinical guidelines have been recognised as an effective way to improve healthcare performance. However, little is known about the uptake and implementation of guidelines by general practitioners in China. The aim of this study was to investigate the guideline use behaviours and needs of practitioners in primary care settings in China.


METHODS
We conducted a cross-sectional survey from December 2015 to May 2016 that included practitioners at 268 institutions in 15 provinces in China. Questionnaire development was informed by the execution of a literature review and consultation of experts. On-site surveys were implemented using a paper questionnaire to minimise missing responses. A multivariate logistic regression analysis was performed to identify factors associated with provider knowledge of and attitudes towards clinical guidelines.


RESULTS
Of the respondents, 91.7% (1568/1708) were aware of clinical guidelines, but only 11.3% (177/1568) frequently used them. The main mechanism by which primary care practitioners accessed guidelines was public search engines (63.4%; 911/1438), and practitioners seldom reported using biomedical databases. The most frequently identified barriers to guideline use were lack of training (49.9%; 778/1560), lack of access (44.6%; 696/1560) and lack of awareness (38.0%; 592/1560). Less than one-quarter of respondents considered current guidelines 'entirely appropriate' for use in primary care (23.5%; 339/1442). Most participants (96.2%; 1509/1568) believed it was necessary to develop primary care guidelines. Provider attitudes towards current guidelines were associated with the location and level of the institution and professional title of the practitioner (p<0.05).


CONCLUSION
Our survey revealed poor knowledge and uptake of clinical guidelines in primary care, and we identified a gap between the needs of practitioners and availability of clinical guidelines for use in primary care in China. In addition, lacking access to and training in guidelines also prevented primary healthcare practitioners from using guidelines in daily practice.
['Zeng|Linan|L|', 'Li|Youping|Y|', 'Zhang|Lingli|L|', 'Liu|Guanjian|G|', 'Zhang|Yang|Y|', 'Zhen|Shangwei|S|', 'Li|Honghao|H|', 'Song|Xue|X|', 'Duan|Yanjun|Y|', 'Yu|Jiajie|J|', 'Wang|Xiaodong|X|']
D002681:China D003430:Cross-Sectional Studies D019983:Guideline Adherence D007722:Health Knowledge, Attitudes, Practice D006282:Health Personnel D006801:Humans D016015:Logistic Models D015999:Multivariate Analysis D011320:Primary Health Care D011795:Surveys and Questionnaires
guidelines primary care cross-sectional survey