Table 2 Attitude towards clinical practice guidelines
Theme | Statements |
|---|---|
Positive attitude towards guidelines | |
Provide evidence-based recommendation | ‘Most known guidelines contain summary of all studies and analyses; so I do not have to go through information in parts’ ‘Because it is supported by evidence from many trials and medications’. ‘Recommendations are based on trials that prove its effectiveness; this is more beneficial than the non-trial ones. It is a logical approach’ |
Cost-effective | ‘It’s cost-effective because it is the best care given’ |
Save time | ‘I think we need less time if we know the investigations to be done. It will not take time’ ‘Save time, more comfortable, more convenient. If the physician is aware of the guidelines, it will not take time’ |
Standardize care | ‘It is to standardize the language we speak and health requirements. Like any other business, it is measurable’ ‘More suited to patient’ ‘Trackable care’ ‘Measurable care’ |
Negative attitude towards guidelines | |
Changing evidence | ‘The CPG will be behind new studies by six months to 1 year; so we can’t think that it represents the latest evidence’ |
Contradicting recommendations | ‘There are some differences from American associations and others. Some say that HBA1c is a diagnostic test; others say it is a follow-up test’ |
Lack of ability of the doctors to read EBM | ‘You cannot be sure unless you learn how to access the paper and decide whether it is weak or strong. At the same time, there should be guidance from the organizing body on how to work around gaps; there should be some reference for people to go to. As an academic, this what I say but as a physician it is not practical; even the ones who know how to analyse an article, do they actually do it? I don’t think so’ |
Not applicable to each individual patient | ‘Individualized treatment. Guidelines don’t fit each individual’ ‘We can take the basic things and the rest can be tailored for each patient. Not every patient has the same case and same treatment’ |
Multiple sources | ‘Which guideline should you follow? Take this one or that? The British, American, or European’ |
Transferability of guidelines to local setting | ‘All adapted’ ‘Because we don’t have another option’ ‘We think it is true for particular circumstances, for that culture’ |