BACKGROUND The prescription of guideline-recommended medication for secondary prevention after acute coronary syndrome has been suboptimal in the past. In the present study, guideline adherence and associated patient, care and hospital characteristics at hospital discharge after acute coronary syndrome were studied. METHODS Charts of patients with acute coronary syndrome discharged from 13 Du...

BACKGROUND The Emergency Medical Communication Centre (EMCC) operators in Norway report using the Norwegian Index for Medical Emergency Assistance (Index), a criteria-based dispatch guideline, in about 75 % of medical emergency calls. The main purpose of a dispatch guideline is to assist the operator in securing a correct response as quickly as possible. The effect of using the guideline on EMC...

BACKGROUND In the management of non-ST-elevation acute coronary syndrome (NSTACS) a gap between guideline-recommended care and actual practice has been reported. A systematic overview of the actual extent of this gap, its potential impact on patient-outcomes, and influential factors is lacking. OBJECTIVE To examine the extent of guideline adherence, to study associations with the occurrence o...

OBJECTIVES Practice nurses in general practices suboptimally adhere to smoking cessation guidelines. Since the effectiveness of their smoking cessation support is greatest when full adherence to these guidelines is achieved, interventions need to be developed to improve practice nurses' guideline adherence, for example, by tailoring their content to adherence determinants. However, the sociocog...

We discuss the challenges of implementing clinical practice guidelines for depression in the primary care setting. Multiple potential barriers can limit physician guideline adherence and translation of research into improved patient outcomes. Six primary barriers relate to providers (lack of awareness, lack of familiarity, lack of agreement, lack of self efficacy, lack of outcome expectancy, an...

BACKGROUND The substantial prevalence of bacterial lower urinary tract infections (LUTIs) in out-of-hours (OOH) primary care is a reason for frequent prescription of antibiotics. Insight in guideline adherence in OOH primary care concerning treatment of LUTIs is lacking. AIMS To check feasibility of the use of OOH routine data to assess guideline adherence for the treatment of LUTI in OOH pri...

BACKGROUND Clinical guidelines are considered important instruments to improve quality in health care. In physiotherapy, insight in adherence to guidelines is limited. Knowledge of adherence is important to identify barriers and to enhance implementation. Purpose of this study is to investigate the ability to adherence to recommendations of the guideline Acute ankle injury, and to identify pati...

BACKGROUND The 2007 Guidelines for the Diagnosis and Management of Asthma provide evidence-based recommendations to improve asthma care. Limited national-level data are available about clinician agreement and adherence to these guidelines. OBJECTIVE To assess clinician-reported adherence with specific guideline recommendations, as well as agreement with and self-efficacy to implement guidelin...

The paper in this issue by Tra et al. [5] addresses implementation. The design of this study has been published separately [6]. The authors report a large retrospective observation on adherence to European Society of Cardiol-ogy (ESC) guidelines on preventive medication after ACSs [7]. In the 13 (out of 91) medical centres in the Nether-lands that were randomly selected for the analysis, overal...

BACKGROUND Implementation of guidelines in clinical practice is difficult. In 2003, the German College of General Practitioners and Family Physicians (DEGAM) released an evidence-based guideline for the management of low back pain (LBP) in primary care. The objective of this study is to explore the acceptance of guideline content and perceived barriers to implementation. METHODS Seventy-two g...