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Table 3 Perceived barriers to the implementation of key recommendations per guideline

From: Why don't physicians adhere to guideline recommendations in practice? An analysis of barriers among Dutch general practitioners

Clinical practice guideline

(Number of key recommendations)

Knowledge

Atttitude

Behaviour

 

Lack of awareness/familiarity

Lack of agreement

Lack of self-efficacy

Lack of outcome expectancy

Inertia previous practice/lack of motivation

Patient factors

Guideline factors

Environmental factors

Asthma among children (7)

+

++

- -

+

- -

-

+

-

Atrial fibrillation (5)

- -

+

- -

- -

-

- -

+

++

Cardiovascular risk management (7)

- -

-

- -

- -

+

-

-

-

Cerebrovascular accident (5)

+

++

-

-

- -

- -

++

- -

Depressive disorder (5)

- -

+

- -

- -

- -

-

- -

- -

Eye inflammation (3)

-

+

-

-

+

+

- -

++

Rhinosinusitis (2)

- -

++

- -

++

- -

++

+

+

Sexually transmitted diseases (4)

++

+

+

-

+

+

++

+

Sleeping disorder (7)

+

-

- -

-

- -

-

- -

-

Thyroid disorder (3)

+

++

+

--

- -

+

-

++

Transient ischemic attack (3)

++

++

-

-

-

-

-

-

Urinary tract infections (5)

+

++

- -

-

-

- -

-

++

Mean 12 guidelines (4.7)

-

+

- -

-

-

-

-

+

  1. -- barrier applicable to 0 to 25% of the key recommendations
  2. - barrier applicable to 25 to 50% of the key recommendations
  3. + barrier applicable to 50 to 75% of the key recommendations
  4. ++ barrier applicable to 75 to 100% of the key recommendations