[Guidelines in general practice--are they read and are they used?].
BACKGROUND
Many guidelines are not developed from systematic models and are not based on high-quality evidence. The existence of a guideline does not in itself lead to changes in practice and many guidelines are not used once they have been issued.


METHODS
A questionnaire on continuing education and the use of guidelines was sent to 1500 general practitioners (GP) and GP assistants in 1321 general practices in Norway. 857 GPs and 948 GP assistants returned the questionnaire.


RESULTS
There was a large variation in the extent to which guidelines were known and used. Many GPs and GP assistants had little knowledge of guidelines published in the Journal of the Norwegian Medical Association or by the Norwegian Medicines Agency, the Norwegian Board of Health or the Norwegian Centre for Health Technology Assessment. There were exceptions: 52% of GPs used the Norwegian College of General Practitioners' treatment programme for diabetes and 77% of GP assistants used the Norwegian quality assurance programme for laboratory services in primary care.


CONCLUSIONS
Guidelines should be based on the best available evidence but this in itself is not enough to ensure that they are adhered to. Effective strategies for implementation are also important.
Treweek
Shaun
S
Avdeling for informerte helsebeslutninger, Nasjonalt kunnskapssenter for helsetjenesten, Postboks 7004 St. Olavs plass, 0130 Oslo.
Flottorp
Signe
S
Fretheim
Atle
A
Håvelsrud
Kari
K
Kristoffersen
Doris Tove
DT
Oxman
Andy
A
Aasland
Olaf Gjerløw
OG
D004502:Education, Medical, Continuing; D005194:Family Practice / Q000193:education; D019983:Guideline Adherence; D006801:Humans; D009664:Norway; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires