Skip to main content
Article thumbnail
Location of Repository

Implementing evidence-based practice in\ud primary care: perceptions of a multifaceted\ud programme to encourage guideline use

By Joyce Marshall, Paula Mead, Karen Jones, Evridiki Kaba and Phillip Tovey


Objective To explore the acceptability of the\ud various elements of a multifaceted intervention\ud designed to facilitate the process of guideline\ud implementation by primary care teams and to\ud understand constraints to the use of guidelines in\ud this setting.\ud Design A descriptive qualitative study using semistructured\ud group interviews.\ud Setting Primary care.\ud Participants 34 general practitioners (GPs), six\ud practice nurses and one practice manager were\ud involved in group interviews from ten general\ud practices.\ud Results The themes identi� ed re� ected the elements\ud of the intervention: bene� ts and problems\ud of critical appraisal workshops; perceptions of the\ud usefulness of guidelines; responses to audit feedback\ud and the impact of facilitation. Even where\ud practitioners were committed to guideline implementation\ud their use was not always straightforward.\ud Aspects such as the maintenance of a good\ud relationship with the patient and the in� uence of\ud colleagues in secondary care were seen as important.\ud Issues of time and resources were also\ud highlighted.\ud Conclusions Implementation of clinical guidelines\ud is a complex activity. Interventions used to\ud encourage their use should be � exible and directly\ud relevant to practical issues. Local ownership of the\ud process is important but agreed deadlines for\ud activity may be important to facilitate action

Topics: R1, RA
Publisher: Radcliffe Publishing
Year: 2002
OAI identifier:

Suggested articles


  1. (1998). A First Class Service. The Stationery O¤ce: London.
  2. (2002). Chest pain. Clinical review: ABC of psychological medicine. doi
  3. (1986). Choices for Healthcare: a practical introduction to the economics of health provision.
  4. (1993). E¡ect of clinical guidelines on medical practice. doi
  5. (1997). Evidence-based Medicine: how to practice and teach EBM. Churchill doi
  6. (1996). Evidence-based practice in primary care. doi
  7. (1999). for Reviews and Dissemination
  8. (1999). General practitioners’ perceptions of e¡ective health care. doi
  9. (1998). Getting research into practice: barriers and bridges to evidence-based practice. doi
  10. (1994). Implementing clinical practice guidelines: can guidelines be used to improve clinical practice? E¡ective Health Care 8:
  11. (2000). Implementing Evidencebased Changes in Healthcare.
  12. (2001). Implementing the results of research and development in clinical and managerial practice. In: Baker M and Kirk S (eds) Research and Development for The NHS: evidence, evaluation and e¡ectiveness.
  13. (2001). Network for Evidence-based Practice (NEBPINY) Research Team
  14. (1996). North of England Evidence-based Guidelines Development Project: summary version of evidence-based guideline for the primary care management of stable angina. doi
  15. (1999). Potential bene ts, limitations and harms of clinical guidelines. doi
  16. (1994). Qualitative data analysis for applied policy research. In: Bryman A and Burgess R (eds) Analysing Qualitative Data. doi
  17. (1995). Qualitative research: rigour and qualitative research. doi
  18. (2000). Sharing the evidence: clinical practice benchmarking to improve continuously the quality of care. doi
  19. (2002). Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. doi
  20. (1997). The New NHS: modern and dependable. The Stationery O¤ce: London.
  21. (1993). Users’ guide to the medical literature II. How to use an article about therapy or prevention.
  22. (2001). Why general practitioners do not implement evidence: qualitative study. doi

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.