Routine use of clinical management guidelines in Australian general practice.
Significant gaps remain between recommendations of evidence-based guidelines and primary health care practice in Australia. This paper aims to evaluate factors associated with the use of guidelines reported by Australian GPs. Secondary analysis was performed on a survey of primary care practitioners which was conducted by the Commonwealth Fund in 2009: 1016 general practitioners responded in Australia (response rate 52%). Two-thirds of Australian GPs reported that they routinely used evidence-based treatment guidelines for the management of four conditions: diabetes, depression, asthma or chronic obstructive pulmonary disease and hypertension - a higher proportion than in most other countries. Having non-medical staff educating patients about self-management, and a system of GP reminders to provide patients with test results or guideline-based intervention or screening tests, were associated with a higher probability of guidelines use. Older GP age was associated with lower probability of guideline usage. The negative association with age of the doctor may reflect a tendency to rely on experience rather than evidence-based guidelines. The association with greater use of reminders and self-management is consistent with the chronic illness model.
Centre for Primary Health Care and Equity, 3rd Floor AGSM Building, University of New South Wales, NSW 2052, Australia.
Mark F
MF
Harris
Centre for Primary Health Care and Equity, 3rd Floor AGSM Building, University of New South Wales, NSW 2052, Australia.
Jane
J
Lloyd
Centre for Primary Health Care and Equity, 3rd Floor AGSM Building, University of New South Wales, NSW 2052, Australia.
Yordanka
Y
Krastev
Centre for Primary Health Care and Equity, 3rd Floor AGSM Building, University of New South Wales, NSW 2052, Australia.
Mahnaz
M
Fanaian
Centre for Primary Health Care and Equity, 3rd Floor AGSM Building, University of New South Wales, NSW 2052, Australia.
Gawaine Powell
GP
Davies
School of Public Health and Community Medicine, University of New South Wales, NSW 2052, Australia.
Nick
N
Zwar
School of Public Health and Community Medicine, University of New South Wales, NSW 2052, Australia.
Siaw-Teng
ST
Liaw
D001315:Australia; D003430:Cross-Sectional Studies; D019317:Evidence-Based Medicine / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D058006:General Practice / Q000379:methods* / Q000592:standards* / Q000706:statistics & numerical data; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011216:Practice Management, Medical / Q000592:standards* / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data