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Table 2 Perceived barriers to guideline use

From: Barriers and facilitators to the implementation of clinical practice guidelines: A cross-sectional survey among physicians in Estonia

Survey question(N = number of respondents) Strongly agree Somewhat agree Neither agree nor disagree Somewhat disagree Strongly disagree
Resource barriers      
Treatment guidelines are hard to implement in daily practice due to lack of medical resources (investigational abilities, etc.) (N = 496) 23 (5%) 137 (28%) 93 (19%) 205 (41%) 38 (8%)
Treatment guidelines are hard to implement in daily practice due to a lack of resources of patients (expensive medicines, etc.) (N = 494) 22 (4%) 130 (26%) 97 (20%) 214 (43%) 31 (6%)
There is no time to search for information (N = 490) 50 (10%) 157 (32%) 40 (8%) 172 (35%) 71 (14%)
System barriers      
Treatment guidelines are not accessible (N = 488) 7 (1%) 69 (14%) 55 (11%) 202 (41%) 155 (32%)
Treatment guidelines are too complicated and it is difficult to find the information (N = 489) 15 (3%) 74 (15%) 60 (12%) 256 (52%) 84 (17%)
Attitudinal barriers      
Treatment guidelines reduce doctors’ autonomy (a ‘cookbook’) (n = 492) 26 (5%) 94 (19%) 51 (10%) 229 (47%) 92 (19%)
Treatment guidelines limit treatment options (N = 483) 16 (3%) 44 (9%) 52 (11%) 267 (55%) 104 (22%)
Treatment guidelines limit flexibility and individual approach (N = 483) 29 (6%) 87 (18%) 52 (11%) 252 (52%) 63 (13%)
There is no need for treatment guidelines as treatment routines exist (N = 490) 5 (1%) 15 (3%) 32 (7%) 220 (45%) 218 (44%)
Patient barriers      
Patients do not want doctors to conform to treatment guidelines (N = 483) 4 (1%) 11 (2%) 179 (37%) 136 (28%) 153 (32%)