Background
Methods
Inclusion and exclusion criteria
Inclusion criteria | Exclusion criteria |
---|---|
Public, patient or carer beliefs, feelings, awareness, understanding, knowledge, attitudes, expectations and perceptions of clinical practice guidelines (and/or guidance). | Opinion pieces, editorials, narrative reviews and protocols. |
Public/patient involvement in guideline development. | |
User-testing of public/patient information tools derived from guidelines. | Public/patient-centred communication/information not related to guidelines or evidence-based recommendations. |
Readability/understandability of public/patient-targeted information materials derived from guidelines. | |
Public health campaigns. | |
Communicating research results to public/patients within the context of a guideline. | Procedure-specific information (e.g. details of surgical operations and their consequences). |
Public/patient versions of guidelines | |
Computer interpretable guidelines for public/patients. | Informed consent for clinical trials. |
Public understanding of science. | |
Knowledge translation tools for public/patients derived from guidelines. | |
English, Finnish, Norwegian, Spanish and German articles. |
Identification of studies
Data extraction
Quality assessment of studies
Data synthesis
Results
Selection of studies
Study characteristics
Author year | Aim | Participants and study location | Key themes identified by reviewers |
---|---|---|---|
Study design | |||
Quality | |||
Akl 2007 [37] | To evaluate the use of symbols and words to present information on the strength of recommendations | 84 participants, 64.1% female, 48.6% graduate - part of community health education programme; USA | Evidence behind recommendations; format issues |
RCT | |||
Fair | |||
Berry 2010 [23] | To gain an understanding of public perceptions of Physical Activity guidelines put forward by a public health agency | 22 participants in five focus groups, 18 to 70 years; Type II diabetes or cardiovascular disease; Canada | Patient as individual; format issues |
Qualitative study | |||
Good | |||
Carman 2010 [6] | To determine how the concept of making health care decisions based on evidence of effectiveness could be translated into language that consumers would understand | 34 consumers in 4 focus groups, 57 interviews and 1558 employees, 18–64; USA | Patient as individual; Guidelines control care; Guidelines as rules; Guidelines for physicians; Communicate with physician;Trustworthiness |
Qualitative study | |||
Fair | |||
Crocetti 2004 [26] | To determine awareness and knowledge of infant feeding guidelines | 102 Primary female caregivers mean age 27 years; 34% African American; 64% completed high school; Maryland, USA | Patient as individual |
Cross sectional study | |||
Good | |||
Dykes 2004 [15] | To evaluate a tool to drive patient centred evidence based recommendations to facilitate guideline adherence | 3 evaluators mean age 71 years, TV literate bedbound patients and carers (higher retirement income); Connecticut, USA | Self management; Format issues |
Qualitative study | |||
Poor | |||
Eaton 2011 [38] | To determine whether an intervention based on patient activation and a physician support tool was more effective than usual care to improve adherence to National Cholesterol Education Program guidelines (USA) | 4105 patients; primary care; mean age 52 control/54 intervention; 96% white; 59% female, southeastern New England, USA. | Communicate with physician, decision making; Self management; Patient as individual. Format issues |
RCT cluster randomised | |||
Good | |||
Elad 2011 [27] | To gauge acceptance of 2007 American Heart Association guidelines on antibiotic prophylaxis after being notified about change by doctor | 51 patients, 58 ± 17 yrs, 40% female with endocarditis; Israel. | Applicability of guideline information; Communicate with physician; Trustworthiness |
Cross sectional study | |||
Good | |||
Faruqi 2000 [16] | To determine views, how to put into practice and disseminate clinical management of diabetes mellitus guidelines | 5-20 participants recruited through Diabetes Australia in four focus groups; Sydney, Australia | Self-management; Communicate with physician; Guidelines for physicians; Format issues |
Qualitative study | |||
Poor | |||
Geiger 2001 [17] | To determine awareness of dietary guidelines and test presentation formats | 40 men and women (25–45); Missouri, USA | Guidelines for physicians; Guidelines control care; format issues |
Qualitative study | |||
Poor | |||
Julian 2010 [18] | To determine knowledge and attitudes of women with menstrual disorders towards the use of evidence based clinical guidelines for their condition | 24 women (22–54) attending secondary care; Leicestershire, England | Guidelines as rules; Guidelines control care; Guidelines for physicians; Patient as individual; |
Qualitative study | |||
Good | |||
Keenan 2002 [29] | To examine knowledge and understanding and factors that influence knowledge - media/nonmedia/age and education | 400 adults over 18 years old, 51.8% college degree, 56% female; Minnesota, USA | Format issues |
Cross sectional study | |||
Fair | |||
McFarlane 2012 [30] | To determine public awareness of National Institute for Health and Care Excellence (NICE) guidelines and their implementation | 1675 respondents (70% female, 61% (45–74 yrs old), 17% health care professionals); mostly England and Wales, UK | Guidelines for physicians; Guidelines control care |
Cross sectional study | |||
Fair | |||
Michie 2005 [39] | To evaluate knowledge of guideline and take up when using behaviourally specific language | 84 mental health users; 41–50 years; 51% women; London, UK | Format issues |
RCT | |||
Poor | |||
Miroballi 2012 [31] | To determine awareness of infection control guidelines | 1399 Cystic Fibrosis patients and their families, 38% patients, 62% family members; USA | Communicate with physician |
Cross sectional study | |||
Fair | |||
Mitchell 2004 [19] | To determine knowledge of evidence based medicine and guidelines | 33 patients with colorectal cancer and 9 carers, 43 to 86 years; 66% male, many had not completed high school; Austin, Victoria, Australia | Communicate with physician |
Qualitative study | |||
Fair | |||
Owen-Smith 2010 [20] | To investigate patients’ and healthcare providers’ experiences of, and preferences for, implicit and explicit healthcare rationing | 56 participants (31 patients, clinicians, healthcare managers); morbid obesity and breast cancer; Bristol, UK | Guidelines control care |
Qualitative study | |||
Fair | |||
Quintana 2001 [21] | To explore how best to use the Internet to make evidence-based preventive health care guidelines available to physicians and consumers | 39 participants (22 men, 17 women, 56% men), 35 to 65 years, experience using the Internet; Canada. | Format issues; self management; Trustworthiness; evidence behind recommendations; Communicate with physician; Decision making |
Qualitative study | |||
Good | |||
Royak-Schaler 2008 [22] | To investigate patient-physician communication from the patient’s perspective about guidelines | 39, age 30–75 (mean age 55), 72% college education, breast cancer survivors, all African American; Baltimore, USA | Self-management; Communicate with physician |
Qualitative study | |||
Fair | |||
SIGN 2011 [34] | To investigate public awareness of Scottish Intercollegiate Guidelines Network (SIGN) guidelines and their implementation | 239 respondents (66% female, 74% 45–74 yrs old, 61% had specific condition or disability); mostly Scotland, UK | Format issues; Evidence behind recommendations; Guidelines improve care; Guidelines for physicians |
Cross sectional study | |||
Fair | |||
Squiers 2011 [35] | To assess how knowledgeable women were about the new recommendations in mammography | 1221 women, 40–74, who had never had breast cancer; USA | Format issues; Evidence behind recommendations; Guidelines control care |
Cross sectional | |||
Good |
Author year | Aim | Participants and study location | Awareness |
---|---|---|---|
Study design | |||
Quality | |||
Berry 2010 [23] | To gain an understanding of public perceptions of Physical Activity guidelines put forward by a public health agency | 22 participants in five focus groups, 18 to 70 years; Type II diabetes or cardiovascular disease; Canada | Lack of awareness |
Qualitative study | |||
Good | |||
Cameron 2007 [24] | To determine Awareness and Knowledge of Canadian Physical Activity Guide (CPAG) guidelines, prompted and unprompted | 8892 adults aged 18 or older from Physical Activity Monitor; 52% female, 83% greater than high school education; Canada | 4% aware of any guidelines for physical activity; 37% prompted aware of CPAG |
Cross sectional study | |||
Fair | |||
Copeland 2005 [25] | To determine awareness of written guidelines that define which conditions require exclusion from the Child Care Centre | 128 parents picking up children at Day Care Centre, 91% female, 69% African American; Baltimore City, USA | 61% aware of guideline |
Cross sectional study | |||
Fair | |||
Crocetti 2004 [26] | To determine awareness and knowledge of infant feeding guidelines | 102 Primary female caregivers mean age 27 years; 34% African American; 64% completed high school; Maryland, USA | 77% aware of guideline |
Cross sectional study | |||
Good | |||
Faruqi 2000 [16] | To determine how to put into practice and disseminate clinical management of diabetes mellitus guidelines | 5-20 participants recruited through Diabetes Australia in four focus groups; Sydney, Australia | Lack of awareness |
Qualitative study | |||
Poor | |||
Geiger 2001 [17] | To determine awareness of dietary guidelines and test presentation formats | 40 men and women (25–45); Missouri, USA | Lack of awareness |
Qualitative study | |||
Fair | |||
Hong 2007 [28] | To determine awareness and knowledge of dietary guidelines | 345 well people - 77% female; 46% <65 years. Randomly selected in one district Seoul urban population. | 32.2% aware of dietary guidelines |
Cross sectional study | |||
Poor | |||
Keenan 2002 [29] | To examine knowledge and understanding and factors that influence knowledge - media/non-media/age and education | 400 adults over 18 years old, 51.8% college degree, 56% female; Minnesota, USA | 45% aware of dietary guidelines |
Cross sectional study | |||
Fair | |||
Mitchell 2004 [19] | To examine knowledge of evidence based medicine and guidelines | 33 patients with colorectal cancer and 9 carers; 43 to 86 yrs old; 66% male; many had not completed high school; Austin, Victoria, Australia | No awareness |
Qualitative study | |||
Fair | |||
Miroballi 2012 [31] | To determine awareness of Infection Control guidelines | 1399 Cystic Fibrosis patients and their families; 38% patients, 62% family members in USA | 65% aware of guidelines |
Cross sectional study | |||
Fair | |||
Nash 2003 [32] | To determine cholesterol guideline awareness | 1163 adults, 56% female, >40 years; Canada | 32% (94/290) aware of guideline |
Cross sectional study | |||
Poor | |||
McFarlane 2012 [30] | To determine public awareness of National Institute for Health and Care Excellence (NICE) guidelines and their implementation | 1675 respondents (70% female, 61% (45–74 yrs old), 17% health care professionals); mostly England and Wales, UK | 79% (824/1040) aware of guidelines |
Cross sectional study | |||
Fair | |||
Owen-Smith 2010 [20] | To investigate patients’ and healthcare providers’ experiences of, and preferences for, implicit and explicit healthcare rationing | 56 participants (31 patients, clinicians, healthcare managers); morbid obesity and breast cancer; Bristol, UK | Only 6/31 patients knew about NICE and what they did and 3 of these patients worked for health service. |
Qualitative study | |||
Fair | |||
Roth 2010 [33] | To investigate knowledge of guidelines and if is this linked to following guidelines | 1940 adolescents (11–15 yrs old); 49% female; England, UK | 11% of children knew about the recommendations. |
Cross sectional study | |||
Fair | |||
Royak-Schaler 2008 [22] | To investigate patient-physician communication from the patient’s perspective about guidelines | 39 participants, 30–75 yrs old (mean age 55), 72% college education, breast cancer survivors, all African American; Baltimore, USA | Lack of awareness |
Qualitative study | |||
Fair | |||
SIGN 2011 [34] | To investigate public awareness of Scottish Intercollegiate Guidelines Network (SIGN) guidelines and their implementation | 239 respondents (66% female, 74% 45–74 yrs old, 61% had specific condition or disability); mostly Scotland, UK | 64% (151/236) aware of guidelines |
Cross sectional study | |||
Fair | |||
Spence 2002 [36] | To investigate awareness of Canada’s Physical Guide to Healthy Active Living | 2719 participants; 18-76+ years; Alberta, Canada | 20% (544/2719) aware of guideline |
Cross sectional study | |||
Fair |
Thematic analysis of the public’s attitudes towards clinical practice guidelines and evidence based recommendations
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‘Applicability of guidelines: Patient as individual, Applicability of information to themselves
-
‘Purpose of guidelines for patient: Communicate with physician; Decision making; Self-management
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‘Purpose of guidelines for health care system and physician: Guidelines control care (restrict/offer, access, cost); Guidelines as rules
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‘Properties of guidelines: Format issues; Trustworthiness; Evidence behind recommendations