Positive attitudes towards priority setting in clinical guidelines among Danish general practitioners: A web based survey


Aims: Increasing focus on improvement and optimisation of the treatment in primary care and reduction of healthcare costs emphasize the need to understand which factors determines adherence and non-adherence to clinical guidelines. In the present study, we examined attitudes towards clinical guidelines in Danish general practitioners (GPs). Methods: We conducted a survey among Danish GPs from all five regions of Denmark. In total, 443 GPs answered the web-based questionnaire that contained questions about attitudes and barriers to clinical guidelines. Results: More than 90% of the GPs reported that they have good knowledge of the guidelines and in general follows the guidelines. A majority of the GPs (81%) found it acceptable that economic considerations are part of the guidelines. The most important factors for non- adherence to guidelines were “need of adjustment to clinical practice” and “lack of confidence in guidelines”. The attitudes to clinical guidelines were not significantly associated with practice characteristics such as gender, years of experience, practice organisation and localisation. Conclusions: Our findings show that clinical guidelines are an integrated or internalised part of everyday practice among GPs in Denmark. Furthermore, the findings indicate that Danish GPs are positive towards applying priority setting in their practice. This is decisive in the light of rising healthcare costs due to development of new expensive technologies and ageing populations that puts pressure on the healthcare system in general and primary healthcare in particular.

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Nielsen, A. , Carlsen, B. and Kjellberg, P. (2013) Positive attitudes towards priority setting in clinical guidelines among Danish general practitioners: A web based survey. Health, 5, 188-192. doi: 10.4236/health.2013.52026.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Field, M. (1990) Attributes of good practice guidelines. In: Clinical Practice Guidelines: Directions for a New Pro gram, National Academy Press, Washington DC, 53-77.
[2] Francke, A.L., Smit, M.C., de Veer, A.J., et al. (2008) Factors influencing the implementation of clinical guide lines for health care professionals: A systematic meta-re view. BMC Medical Informatics and Decision Making, 8, 38. doi:10.1186/1472-6947-8-38
[3] Carlsen, B. and Kjellberg, P.K. (2010) Guidelines; from foe to friend? Comparative interviews with GPs in Nor way and Denmark. BMC Health Service Research, 10, 17. doi:10.1186/1472-6963-10-17
[4] Jones, R., Dowie, R. and Robinson, M. (2000) Guidelines implementation and research in the future. Family Practice, 17, 36-37. doi:10.1093/fampra/17.suppl_1.S36
[5] Dowie, R., Robinson, M. and Jones, R. (2000) Research on guidelines implementation in primary care. Introduction. Family Practice, 17, 1-2. doi:10.1093/fampra/17.suppl_1.S1
[6] The Danish College of General Practitioners (1996) Kli niske vejledninger i almen medicin [Clinical guidelines in general practice]. DSAM, Copenhagen.
[7] Carlsen, B. and Bringedal, B. (2011) Attitudes to clinical guidelines—Do GPs differ from other medical doctors? BMJ Quality and Safety, 20, 158-162. doi:10.1136/bmjqs.2009.034249
[8] Cabana, M.D., Rand, C.S., Powe, N.R., et al. (1999) Why don’t physicians follow clinical practice guidelines? A framework for improvement. Journal of the American Medical Association, 282, 1458-1465. doi:10.1001/jama.282.15.1458
[9] Carlsen, B., Glenton, C. and Pope, C. (2007) Thoushalt versus thou shalt not: A meta-synthesis of GPs’ attitudes to clinical practice guidelines. British Journal of General Practice, 57, 971-978. doi:10.3399/096016407782604820
[10] Farquhar, C.M., Kofa, E.W. and Slutsky, J.R. (2002) Clinicians’ attitudes to clinical practice guidelines: A systematic review. Medical Journal of Australia, 177, 502-506.
[11] Grimshaw, J., Eccles, M. and Tetroe, J. (2004) Imple menting clinical guidelines: Current evidence and future implications. Journal of Continuing Education in the Health Professions, 24, S31-S37. doi:10.1002/chp.1340240506
[12] Carlsen, B. and Norheim, O.F. (2008) “What lies beneath it all?”—An interview study of GPs’ attitudes to the use of guidelines. BMC Health Service Research, 8, 218. doi:10.1186/1472-6963-8-218
[13] Institute for rational pharmacotherapy (2011). http://www.irf.dk/dk/om_irf/irfs_historie/
[14] Danish Medical Association (2010) Doctors use of clinical guidelines [S?dan bruger l?ger kliniske retningslin jer].
[15] Treweek, S., Flottorp, S., Fretheim, A., et al. (2005) Guide lines in general practice—Are they read and are they used? Tidsskrift for Den norske Laegeforening, 125, 300-303.
[16] Woolf, S.H., Grol, R., Hutchinson, A., et al. (1999) Clinical guidelines: Potential benefits, limitations, and harms of clinical guidelines. British Medical Journal, 318, 527 530. doi:10.1136/bmj.318.7182.527
[17] Organisation of general practitioners in Denmark (2011). http://www.laeger.dk/portal/page/portal/LAEGERDK/Laegerdk/P_L_O/Om%20PLO/Tal%20og%20publikationer/Statistik%20om%20almen%20praksis/praksist%C3%A6l ling_2009.pdf
[18] Matteson, K.A., Anderson, B.L., Pinto, S.B., Lopes, V., Schulkin, J. and Clark, M.A. (2011) Surveying ourselves: Examining the use of a web-based approach for a physician survey. Evaluation & the Health Professions, 34, 448 463. doi:10.1177/0163278710391086
[19] Braithwaite, D., Emery, J., de Lusignan, S. and Sutton, S. (2003) Using the internet to conduct surveys of health professionals: A valid alternative? Family Practice, 20, 545-551. doi:10.1093/fampra/cmg509
[20] Carlsen, B., Glenton, C. and Pope, C. (2007) Thou shalt versus thou shalt not. A qualitative meta-synthesis of GPs’ attitudes to clinical practice guidelines. British Journal of General Practice, 57, 971-978. doi:10.3399/096016407782604820

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