Evaluating the Message

The Relationship Between Compliance Rate and the Subject of a Practice Guideline

Dados Bibliográficos

ID9104345
AutoresRoberto Grilli (0000-0001-9425-7170, Policy Analysis (United States), autor correspondente), Jonathan Lomas (autor correspondente)
Ano1994
Volume32
Fascículo3
Páginas202-213
Data de publicação1994-03-01
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoMedical Care (JOURNAL)
Identificadores do periódicoISSN: 0025-7079 • E-ISSN: 1537-1948
EditoraOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00005650-199403000-00002
PMID8145598
OpenAlexW1993763497
IdiomaEN
Citações recebidas21
Referências citadas10

To explore the relationship between providers' compliance and some key aspects of the clinical messages in practice guidelines, studies published in the English language medical literature between 1980 and 1991 were retrieved through MEDLINE and through relevant review articles in the field. All published studies providing compliance rates with practice guidelines and endorsed by official organizations were eligible for the study. The clinical content and the reported compliance rate were gathered for each recommendation in the 23 studies selected. The medical and surgical procedures addressed by 143 recommendations were identified according to specialty area, type of procedure (diagnostic, surgical, etc.) and were independently classified by the authors as being high or low on characteristics thought to influence diffusion:complexity, trialability and observability. The mean compliance rate with the 143 clinical recommendations was 54.5% (95% CI: 50.2%-58.9%), with those in the specialty areas of cardiology and oncology showing the highest compliance (mean 63.6% and 62.2%, respectively). Recommendations concerning procedures with high complexity had lower compliance rates than those low on complexity (41.9% vs. 55.9%; P = 0.05), and those judged to be high on trialability had higher compliance rates than those low on trialability (55.6% vs 36.8%; P = 0.03). Overall, all the characteristics of the clinical recommendations considered in the practice guidelines could account for no more than 47% of the observed variability in compliance rates. The target area of practice and the complexity and trialability of the recommended procedure appear to be useful, if partial, predictors of the level of compliance with a practice guideline

Clinical Practice · Compliance (psychology) · Cross-sectional study · Family medicine · Guideline · MEDLINE · Pathology · Specialty · Clinical practice guidelines implementation · Electronic Health Records Systems · Health Policy Implementation Science · Medicine · Psychology