The use of clinical practice guidelines in General Practice : a study to examine the effect of implementing radiological guidelines in General Practice clinic in the Al-Ain district of the United Arab Emirates
This was the first study undertaken in the United Arab Emirates, to investigate clinical practice guidelines. There were three parts to the investigation, 1. A survey of the knowledge, attitude and beliefs about clinical practice guidelines among General Practitioners; 2. A research enquiry into the effects of the guidelines of the Royal College of Radiologists' of the United Kingdom, on the request behaviour of General Practitioners; 3. A further enquiry into the effect of introducing information regarding the cost of radiograph ordered, on the 'request' behaviour of General Practitioners. The study took place among General Practitioners employed within the Al-Ain Medical District, in the United Arab Emirates. Important recommendations derived from this research were - The high percentage of inappropriate radiological referrals in the Practices studied is an alarming indication of substandard care provision, to counteract which, clinical practice guidelines are still highly recommended; Educational programmes are required which should be directed towards improving the knowledge of General Practitioners of the concept of clinical practice guidelines; Implementation of clinical practice guidelines requires an inclusive approach in planning. The strategy should be directed towards doctors, patients, the setting, administration and appropriate guidelines; how they are developed, evaluated and presented. The planning should ensure continuous reinforcement of the guidelines and appropriate marketing and public persuasion. In addition, a continuous evaluation system is essential to assess performance which could then be improved; Strategies which are more likely to be effective are those which involve the end user; in this case, the General Practitioner and those operating directly upon the consultation between the doctor and the patient. Examples of such strategies include, feedback on practice, opinion leaders, patient specific reminders and educational outreach visits; the guidelines adopted by a respected 'organisation' ensure a greater acceptance.