Use of the World Wide Web to implement clinical practice guidelines: a feasibility study

Details

Serval ID
serval:BIB_35CC7E463B88
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Use of the World Wide Web to implement clinical practice guidelines: a feasibility study
Journal
Journal of Medical Internet Research
Author(s)
Jeannot  Jean-Gabriel, Scherer  Fredy, Pittet  Valérie, Burnand  Bernard, Vader  John-Paul
ISSN
1438-8871
Publication state
Published
Issued date
2003
Volume
5
Number
2
Pages
e12
Notes
Réf. IUMSP: R 03/62
SAPHIRID:44901 --- Old url value: http://www.jmir.org/2003/2/e12/
Abstract
BACKGROUND: Important efforts have been invested in the past few years in the development of quality clinical guidelines. However, the means for the effective dissemination of guidelines to practicing physicians have not been determined. Several studies have examined the possibilities offered by the World Wide Web (the Web), but studies examining the implementation of clinical guidelines in actual practice are clearly lacking. OBJECTIVE: This study assessed the potential of the Web to implement clinical practice guidelines in actual clinical settings. It also documents the obstacles perceived by the physicians in their use of guidelines on the Internet to determine the role that the Web can play in the implementation of guidelines in practice. METHODS: Two guidelines were developed using a standardized panel method and made available via the Web. One concerned indications for low-back surgery and the other dealt with indications for upper and lower digestive endoscopies. To identify obstacles to their use in clinical practice, 20 physicians were asked to consult the guidelines during consultations with patients. Answers were collected using 3 different questionnaires. RESULTS: Questionnaires were completed for consultations involving 213 patients. Less than 50% of the physicians have direct access to the Internet in their examination room. For 75%, the use of the guidelines was easy and the time required to consult them acceptable (3.4 minutes on average, or 12% of the time spent with the patient). The fear that use of such guidelines might interfere with the physician-patient relationship was mentioned as a reason for not consulting the guidelines for 27 consultations. Taking into account their experience with the Web, 75% of the physicians considered that the Web has a great or very-great potential for the dissemination of guidelines and 78% indicated that they would use such guidelines if they became generally available for clinical questions that concerned them. Only 3 physicians had consulted guidelines on the Web prior to this study. CONCLUSIONS: The acceptance of use of clinical practice guidelines via the Web is high. The main limits to further use of such Web-based guidelines seem to be the lack of a computer connection in the physician's office or examining room and the fear that use of such guidelines might interfere with the physician-patient relationship. Though most participants appreciate the considerable potential of the Web for disseminating guidelines, only a small handful regularly use guidelines available on the Web. There are still numerous obstacles to the regular use of guidelines in clinical practice, some related to the physicians, others to the guidelines themselves. [Authors]
Keywords
Internet , Practice Guidelines as Topic , Feasibility Studies , Questionnaires
Pubmed
Web of science
Open Access
Yes
Create date
06/03/2008 16:31
Last modification date
20/08/2019 14:23
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