Dissemination of guidelines: which sources do physicians use in order to be informed?

Objective. To gain insight into processes of dissemination of clinical guidelines, sources of information physicians use to become informed about them, and factors influencing these processes. Design. National survey among a random sample of family physicians using a structured questionnaire. Setting. Family practice in The Netherlands; evaluation of a national programme of (evidence based) practice guidelines. Study participants. A random sample of 1531 family physicians. Main measures. Being informed about national guidelines and specific recommendations from these guidelines; being informed about specific educational programmes on the national guidelines; sources of information used in order to be informed; doctor and practice characteristics. Results. The response rate was 67%, the responders being younger than the non-responders. The scientific journal for family physicians proved to be the most important source of information (85%), discussing the guidelines in the local family doctor group was also important (53%). Following continuing medical education courses was less important (33%). On average 80 % knew about the different guidelines and recommendations, 63 % about the educational programmes. Doctors who use the scientific journal as a source, who are members of the professional organization of family doctors, who are younger and who are actively involved in education on family medicine, proved to be better informed. Conclusions. Segmentation of the target group is necessary for effective dissemination of guidelines or new research findings. For some doctors it is desirable to make evidence available quickly, for others spreading the guidelines through the local network may be effective, while for another group a more active, personal approach may be necessary