Understanding the role of guidelines in clinical decision-making and clinical practice: a qualitative study


Nephrologists’ perspectives on the effect of guidelines on clinical practice: a semi-structured interview study
Irving MJ, Tong A, Rychetnik L, Walker RG, Frommer MS, Craig JC. American Journal of Kidney Diseases 2010; 55: 241-249.
[PubMed abstract]


Semi-structured, face to face interviews were undertaken with 19 nephrologists purposively sampled from a variety of clinical settings across Australia.

Participants were asked about their views on nephrology clinical practice guidelines, which included the CARI Guidelines, and international guidelines and other influences on their clinical practice.

Four major themes were identified:

  1. trust in the CARI process and output;
  2. the function of guidelines in clinical practice;
  3. non-guideline influences on clinical decision making;
  4. facilitators of guideline implementation.

Conclusion: Evidence-based guidelines strongly impact on the clinical decision-making of Australian nephrologists but are only one input. Improvements in the evidence which underpins guidelines and improvements in the content and formatting of guidelines are likely to make them more influential on decision making.