Routine use of clinical management guidelines in Australian general practice
Mark F. Harris A C , Jane Lloyd A , Yordanka Krastev A , Mahnaz Fanaian A , Gawaine Powell Davies A , Nick Zwar B and Siaw-Teng Liaw B
+ Author Affiliations
- Author Affiliations
A Centre for Primary Health Care and Equity, 3rd Floor AGSM Building, University of New South Wales, NSW 2052, Australia.
B School of Public Health and Community Medicine, University of New South Wales, NSW 2052, Australia.
C Corresponding author. Email: m.f.harris@unsw.edu.au
Australian Journal of Primary Health 20(1) 41-46 https://doi.org/10.1071/PY12078
Submitted: 12 June 2012 Accepted: 19 September 2012 Published: 18 October 2012
Abstract
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.
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