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Questionnaires used to assess barriers of clinical guideline use among physicians are not comprehensive, reliable, or valid: a scoping review

Author: Willson, M.L. · Vernooij, R.W.M. · Gagliardi, A.R. · Armstrong, M. · Bernhardsson, S. · Brouwers, M. · Bussières, A. · Fleuren, M.A.H. · Gali, K. · Huckson, S. · Jones, S. · Lewis, S.Z. · James, R. · Marshall, C. · Mazza, D.
Type:article
Date:2017
Source:Journal of Clinical Epidemiology, 86, 25-38
Identifier: 783170
doi: doi:10.1016/j.jclinepi.2016.12.012
Keywords: Health · Clinical practice guidelines · Barriers; Implementation · Questionnaires · Questionnaire design · Scoping review · Healthy for Life · Healthy Living · Life · CH - Child Health · ELSS - Earth, Life and Social Sciences

Abstract

Objective This study described the number and characteristics of questionnaires used to assess barriers of guideline use among physicians. Study Design and Setting A scoping review was conducted. MEDLINE and EMBASE were searched from 2005 to June 2016. English-language studies that administered a questionnaire to assess barriers of guideline use among practicing physicians were eligible. Summary statistics were used to report study and questionnaire characteristics. Questionnaire content was assessed with a checklist of 57 known barriers. Results Each of the 178 included studies administered a unique questionnaire. The number of questionnaires increased yearly from 2005 to 2015. Few were pilot-tested (50, 28.1%) or tested for psychometric properties (3, 1.7%). Two were based on theory. None probed for the full range of known barriers. Ten included a free-text option. The majority assessed professional barriers (177, 99.4%) but few of the 14 factors within this domain. Questionnaire characteristics did not change over time. Conclusion Organizations administered questionnaires that were not reliable or valid and did not comprehensively assess barriers and may have selected interventions unlikely to promote guideline use. Research is needed to construct a questionnaire that is practical, adaptable, and robust and leads to the selection of interventions that support guideline use.