Awareness and perceptions of published osteoporosis clinical guidelines - A survey of primary care practitioners in the Cape Town metropolitan area
Background: Despite the widespread production and dissemination of clinical practice guidelines, both worldwide and in South Africa, they have not resulted in the expected improvements in quality of care and patent outcomes. There are limited studies concerning the impact of South African-developed guidelines on local physician behaviour and knowledge. Awareness of a guideline is a necessary prerequisite for its successful implementation. This study aimed to survey primary care practitioners in Cape Town employed in both the private and state sectors on their awareness and perceptions of the Osteoporosis Clinical Guidelines, published in the South African Medical Journal in September 2000. Methods: A descriptive, cross-sectional survey design was used. A telephonic survey of 150 randomised Cape Town primary care practitioners was conducted (100 private general practitioners and 50 public sector primary care practitioners). A survey instrument developed for the study was applied in a standardised manner. The respondent levels of awareness and perceptions of the published guideline on osteoporom were evaluated. Results: A total of 18.7% (95% confidence interval 12.5-24.90%) of the respondents reported being aware of the clinical guidelines. Of the primary care practitioners who were surveyed, 12.7% (95% confidence interval 7.4-18%) reported having read the guidelines. There was no difference in reported awareness of the guidelines between doctors working in the private and public sectors. The respondents who had read the guidelines were generally well disposed towards them. Significantly fewer public sector primary care practitioners felt able to implement the guidelines than private general practitioners - organisational barriers were most commonly cited as barriers to implementation. Conclusion: Passive dissemination of the Osteoporosis Clinical Guidelines resulted in low levels of awareness among the surveyed group. This result has implications regarding future clinical guideline dissemination and implementation in South Africa. Further attention needs to be focused on developing implementation and dissemination strategies of evidence-based guidelines in South Africa.