ArticleBMJ open2018
Factors hindering the adherence to clinical practice guideline for diabetes mellitus in the Palestinian primary healthcare clinics: a qualitative study.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Implementation strategies for evidence-based management of type 2 diabetes at primary healthcare facilities in low- and middle-income countries and related barriers and facilitators: a scoping review.Implementation science communications · 2026Pooled it
- Article
- Development and Validation of a Nurse-Specific Scale to Assess Influencing Factors in Clinical Practice Guideline Implementation: An i-PARIHS-Based Study.Journal of nursing management · 2026Article
- Analytical validation of Exandra: a clinical decision support system for promoting guideline-directed therapy of type-2 diabetes in primary care - a collaborative study with experts from Diabetes Canada.BMC medical informatics and decision making · 2025Article
- Article
- [Challenges and current approaches in the development of psychiatric living guidelines in Germany].Der Nervenarzt · 2023Review
- Understanding factors influencing the use of clinical guidelines in low-income and middle-income settings: a scoping review.BMJ open · 2023Article
- A scoping review of theories used to investigate clinician adherence to clinical practice guidelines.International journal of clinical pharmacy · 2023Article
- Factors Associated with Adherence to Treatment in Patients with HIV and Diabetes Mellitus.Journal of personalized medicine · 2023Article
- Article
- Barriers to and Facilitators of Adherence to Clinical Practice Guidelines in the Middle East and North Africa Region: A Systematic Review.Healthcare (Basel, Switzerland) · 2020Review
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Authors and funding
6 authors.
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Abstract
objectiveDespite a high number of the internationally produced and implemented clinical guidelines, the adherence with them is still low in healthcare. This study aimed at exploring the perspectives and experiences of senior doctors and nurses towards the barriers of adherence to diabetes guideline.
settingThe Palestinian Primary Health Care-Ministry of Health (PHC-MoH) and Primary Health Care-United Nations Relief and Works Agency for Palestine Refugees in the Near East (PHC- UNRWA) in Gaza Strip.
participantsIndividual face-to-face in-depth interviews were conducted with 20 senior doctors and nurses who were purposefully selected.
methodsQualitative design was employed using the theoretical framework by Cabana
resultsThe key theme barriers identified by participants that emerged from the analysed data were in regard of the PHC-MoH lack reimbursement, lack of resources and lack of the guideline trustworthiness, and in regard of PHC-UNRWA the time constraints and the lack of the guideline trustworthiness. The two key subthemes elicited from the qualitative analysis were the outdated guideline and lack of auditing and feedback.
conclusionThe analysis identified a wide range of barriers against the adherence to diabetes guideline within the PHC-MoH and PHC-UNRWA. The environmental-related and guideline-related barriers were the most prominent factors influencing the guideline adherence. Our study can inform the policy makers and senior managers to develop a tailored interventions that can target the elicited barriers through a multifaceted implementation strategy.
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