چکیده (انگلیسی):

Background:The potential of clinical practice guidelines has not been realized due to inconsistent adoption in
clinical practice. Optimising intrinsic characteristics of guidelines (e.g., its wording and format) that are associated
with uptake (as perceived by their end users) may have potential. Using findings from a realist review on guideline
uptake and consultation with experts in guideline development, we designed aconceptualversion of a future tool
called Guideline Implementability Tool (GUIDE-IT). The tool will aim to involve family physicians in the guideline
development process by providing a process to assess draft guideline recommendations. This feedback will then be
given back to developers to consider when finalizing the recommendations. As guideline characteristics are best
assessed by end-users, the objectives of the current study were to explore how family physicians perceive guideline
implementability, and to determine what components should comprise the final GUIDE-IT prototype.
Methods:We conducted a qualitative study with family physicians inToronto, Ontario. Two experienced
investigators conducted one-hour interviews with family physicians using a semi-structured interview guide to
1) elicit feedback on perceptions on guideline implementability; 2) to generate a discussion in response to three
draft recommendations; and 3) to provide feedback on the conceptual GUIDE-IT. Sessions were audio taped and
transcribed verbatim. Data collection and analysis were guided by content analyses.
Results:20 family physicians participated. They perceived guideline uptake according to facilitators and barriers
across 6 categories of guideline implementability (format, content, language, usability, development, and the
practice environment). Participants’ feedback on 3 draft guideline recommendations were grouped according to
guideline perception, cognition, and agreement. When asked to comment on GUIDE-IT, most respondents believed
that the tool would be useful, but urged to involve“regular” or community family physicians in the process, and
suggested that an online system would be the most efficient way to deliver it.
Conclusions:Our study identified facilitators and barriers of guideline implementability from the perspective of
community and academic family physicians that will be used to build our GUIDE-IT prototype. Our findings build
on current knowledge by showing that family physicians perceive guideline uptake mostly according to factors that
are in the control of guideline developers.