Background: It is important to tailor guideline implementation by first assessing potential barriers. Questionnaires are one tool for assessing barriers. Physicians are often the target of questionnaires and we lack knowledge of the types of questionnaires used for this purpose.
Objectives: To describe the characteristics of questionnaires used to assess physician-reported barriers of guideline implementation.
Methods: We conducted a scoping review and searched MEDLINE and Embase from 2005 to 2014. We included English language studies that described guideline implementation barrier questionnaires. Triplicate study screening and data extraction occurred. Data were extracted on study characteristics, clinical topic, respondent setting and specialty, mode of administration, response options, underlying theory, validation and content (barrier) domains based on the Flottorp et al. framework (1). Findings were reported as frequencies and percentages.
Results: Among 174 unique questionnaires, half addressed overall management of a disease with the most common diseases surveyed being cancer and cardiovascular disease (20%, 18%, respectively). Online administration increased over time as did the number of questionnaires published. No questionnaires were based on theory and fewer than one-third were validated prior to use. All but one questionnaire (99.4%) addressed individual health professional barriers, in particular, self-reported behaviour. The remaining six barrier domains and 40 sub-domains were included in few questionnaires, and only ten included a free-text response option to probe for barriers. This did not change over time.
Conclusions: Questionnaires did not adequately assess guideline implementation barriers. Further research is needed to develop and validate a guideline barriers questionnaire. The selection and tailoring of guideline implementation interventions is not informed by valid information about barriers. Guideline developers and implementers may need a standardized questionnaire that could be adapted for their constituents.
1. Flottorp SA, et al. Implement Science 2013; 8:1–11