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Table 2 Characteristics of studies and themes identified in thematic analysis of attitudes to clinical practice guidelines (19 included studies)

From: Patient and public attitudes to and awareness of clinical practice guidelines: a systematic review with thematic and narrative syntheses

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

  1. RCT: randomised controlled trial.