Skip Navigation


Hum. Reprod. Advance Access originally published online on July 29, 2005
Human Reproduction 2005 20(12):3301-3306; doi:10.1093/humrep/dei220
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF ) Freely available
Right arrow All Versions of this Article:
20/12/3301    most recent
dei220v2
dei220v1
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (4)
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Haagen, E.C.
Right arrow Articles by Kremer, J.A.M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Haagen, E.C.
Right arrow Articles by Kremer, J.A.M.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Barriers to physician adherence to a subfertility guideline

E.C. Haagen1,2, W.L.D.M. Nelen1,2, R.P.M.G. Hermens2, D.D.M. Braat1, R.P.T.M. Grol2 and J.A.M. Kremer1,3

1 Department of Obstetrics and Gynaecology and 2 Centre for Quality of Care Research (WOK), Radboud University, Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands

3 To whom correspondence should be addressed. E-mail: j.kremer{at}obgyn.umcn.nl

BACKGROUND: Guidelines aim to improve clinical practice but are not self-implementing. Insight into barriers to physician guideline adherence is crucial for development of effective implementation strategies. The study aim was to identify barriers to physician adherence to an intrauterine insemination (IUI) guideline of the Dutch Society of Obstetrics and Gynaecology. METHODS: We conducted a cross-sectional survey among all Dutch gynaecologists, residents and fertility physicians (n = 860), using written questionnaires that were based on information obtained in focus group discussions. We investigated barriers related to physicians’ knowledge and attitudes, and external barriers. RESULTS: The response rate was 65%. We used 344 questionnaires for analysis. Physicians’ knowledge was adequate, with a median unfamiliarity rate with each of the 31 key guideline recommendations of 12%. Physicians’ attitudes were generally positive, especially regarding guideline development and quality. Important attitude-related barriers included physicians’ lack of self-efficacy regarding physician–patient communication and poor outcome expectancy. External barriers were mostly related to specific patient characteristics and associated with higher age of physicians and fewer consultations for fertility problems per week. CONCLUSIONS: Multiple barriers impede physician adherence to subfertility guidelines, mainly physicians’ lack of self-efficacy and low outcome expectancy. Both physicians and patients play an important role in future implementation interventions to optimize subfertility care.

Key words: barriers/guidelines/implementation/intrauterine insemination/subfertility


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Hum Reprod UpdateHome page
A. N. Andersen, E. Carlsen, and A. Loft
Trends in the use of intracytoplasmatic sperm injection marked variability between countries
Hum. Reprod. Update, August 16, 2008; (2008) dmn032v1.
[Abstract] [Full Text] [PDF]

Home page
 Hum ReprodHome page
S.M. Mourad, W.L.D.M. Nelen, R.P.M.G. Hermens, L.F. Bancsi, D.D.M. Braat, G.A. Zielhuis, R.P.T.M. Grol, and J.A.M. Kremer
Variation in subfertility care measured by guideline-based performance indicators
Hum. Reprod., July 24, 2008; (2008) den281v1.
[Abstract] [Full Text] [PDF]

Home page
 Hum ReprodHome page
A. S. Svanberg, G. Sydsjo, K. E. Selling, and C. Lampic
Attitudes towards gamete donation among Swedish gynaecologists and obstetricians
Hum. Reprod., April 1, 2008; 23(4): 904 - 911.
[Abstract] [Full Text] [PDF]


Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.