GENERAL PRACTITIONERS AND CLINICAL GUIDELINES

Abstract

Objective: To assess the attitudes of general practitioners in Harare, Zimbabwe, towards the
use of clinical practice guidelines (CPG's).
Design: Cross sectional survey.
Setting: General practitioners in private practice within the urban Harare (Zimbabwe)
environs.
Subjects: Two hundred and thirty two general practitioners in Harare, Zimbabwe.
Main outcome measures: The response to a questionnaire enlisting attitudes to CPGs.
Results: Questionnaires were sent to 232 general practitioners. Of these, 137 (59.1%)
returned a completed questionnaire. Among the respondents, 95.6% felt that general
practitioners should be involved in the development of guidelines, 72.6% had read at least
one guideline, 65.9% were prepared to use guidelines in their practice, 61.6% thought that
guidelines would improve their treatment ability, and 59.7 % thought that guidelines would
improve their knowledge of disease. 76.5 % felt that the government should not legislate,
66.2% felt that guidelines reduce practitioners' flexibility and 57.9% felt that guidelines
wrould not improve their diagnostic ability.
Conclusion: The respondents were, in general, favourabl y disposed towards CPGs. Most had
already read some guidelines, and about two thirds were prepared to use them. Almost all
respondents felt that general practitioners should be involved in the development of
guidelines for use in general practice. These general practitioners felt that guidelines were
likely to help them treat patients than to make a diagnosis. Despite these favourable attitudes,
many practitioners felt that guidelines would limit their personal flexibility in caring for
patients. Organisations developing or implementing CPGs in general practice should
address these concerns.