Family physicians' perspectives on practice guidelines related to cancer control.
BACKGROUND
Family physicians (FPs) play an important role in cancer control. While FPs' attitudes towards, and use of guidelines in general have been explored, no study has looked at the needs of FPs with respect to guidelines for the continuum of cancer control. The objective of this study was to understand which guideline topics FPs consider important.


METHODS
Five group interviews were conducted by telephone with FPs from across Ontario, Canada. Transcripts were analyzed inductively. Content analysis identified emergent themes. Themes are illustrated by representative quotes taken from the transcripts.


RESULTS
The main areas where FPs felt guidelines were needed most included screening - a traditional area of responsibility for FPs - and treatment and follow-up - areas where they felt they lacked the knowledge to best support patients. Confusion over best practice when faced with conflicting guidelines varied according to disease site. FPs defined good guideline formats; the most often cited forms of presentation were tear-off sheets to use interactively with patients, or a binder. Computer-based dissemination was acknowledged as the best way of widely distributing material that needs frequent updates. However, until computer use is a common aspect of practice, mail was considered the most viable method of dissemination. Guidelines designed for use by patients were supported by FPs.


CONCLUSIONS
Preferred guideline topics, format, dissemination methods and role of patient guidelines identified by FPs in this study reflect the nature of their practice situations. Guideline developers and those supporting use of evidence-based guidelines (e.g., Canadian Strategy for Cancer Control) have a responsibility to ensure that FPs are provided with the resources they identify as important, and to provide them in a format that will best support their use.
Zitzelsberger
Louise
L
Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa Hospital, Canada. lzitzelsberger@ohri.ca
Grunfeld
Eva
E
Graham
Ian D
ID
D000328:Adult; D001291:Attitude of Health Personnel; D019985:Benchmarking; D002983:Clinical Competence / Q000592:standards; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000503:physiopathology; D003266:Continuity of Patient Care / Q000592:standards*; D005194:Family Practice / Q000592:standards*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008403:Mass Screening / Q000592:standards; D009864:Ontario; D010166:Palliative Care / Q000592:standards; D010821:Physicians, Family / Q000523:psychology* / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic / Q000592:standards*; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000503:physiopathology