Evidence map›Paper›PMID 32460797›Full record

SynthesisImplementation science : IS2020

Clinicians' attitudes and perceived barriers and facilitators to cancer treatment clinical practice guideline adherence: a systematic review of qualitative and quantitative literature.

Mia Bierbaum, Frances Rapport, Gaston Arnolda, Brona Nic Giolla Easpaig, Klay Lamprell, Karen Hutchinson, Geoff P Delaney, Winston Liauw, Richard Kefford, Ian Olver and 1 more

Open access · goldAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Implementation science : IS, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 7 pooled it
10.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

54 citing papers in PubMed, 7 syntheses or guidelines pooled it, 107 citations in OpenAlex.

  1. Exploring disparities in adherence to colorectal cancer clinical practice guidelines and associated survival outcomes: a systematic review and meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Article
  9. Article
  10. Article
  11. Article
  12. Review
  13. Article
  14. Article
  15. Article
  16. Review
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 2 countries.

Mia BierbaumAustralian Institute of Health Innovation (AIHI), Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2019, Australia. mia.bierbaum@hdr.mq.edu.au.
Frances RapportAustralian Institute of Health Innovation (AIHI), Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2019, Australia.
Gaston ArnoldaAustralian Institute of Health Innovation (AIHI), Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2019, Australia.
Brona Nic Giolla EaspaigAustralian Institute of Health Innovation (AIHI), Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2019, Australia.
Klay LamprellAustralian Institute of Health Innovation (AIHI), Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2019, Australia.
Karen HutchinsonAustralian Institute of Health Innovation (AIHI), Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2019, Australia.
Geoff P DelaneyCentre for Research Excellence in Implementation Science in Oncology, AIHI, Macquarie University, Sydney, Australia.
Winston LiauwCentre for Research Excellence in Implementation Science in Oncology, AIHI, Macquarie University, Sydney, Australia.
Richard KeffordCentre for Research Excellence in Implementation Science in Oncology, AIHI, Macquarie University, Sydney, Australia.
Ian OlverCentre for Research Excellence in Implementation Science in Oncology, AIHI, Macquarie University, Sydney, Australia.
Jeffrey BraithwaiteAustralian Institute of Health Innovation (AIHI), Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2019, Australia.
Macquarie University · AUSouth Eastern Sydney Local Health District · AUSouth Western Sydney Local Health District · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClinical Practice Guidelines (CPGs) synthesize the best available evidence to guide clinician and patient decision making. There are a multitude of barriers and facilitators to clinicians adhering to CPGs; however, little is known about active cancer treatment CPG adherence specifically. This systematic review sought to identify clinician attitudes, and perceived barriers and facilitators to active cancer treatment CPG adherence.

methodsA systematic search was undertaken of five databases; Ovid Medline, PsychInfo, Embase, Scopus, CINAHL, and PROQUEST. The retrieved abstracts were screened for eligibility against inclusion criteria, and a full text review was conducted of all eligible studies. Data were extracted, and a quality assessment was conducted of all included studies. The qualitative papers were thematically analyzed. Attitudes, barriers, and facilitating factors extracted from the quantitative papers were categorized within the qualitative thematic framework.

resultsThe search resulted in the identification of 9676 titles. After duplicates were removed, abstracts screened, and full texts reviewed, 15 studies were included. Four themes were identified which related to negative clinician attitudes and barriers to active cancer treatment CPG adherence: (1) concern over CPG content and currency of CPGs; (2) concern about the evidence underpinning CPGs; (3) clinician uncertainty and negative perceptions of CPGs; and (4) organizational and patient factors. The review also identified four themes related to positive attitudes and facilitators to active cancer treatment CPG adherence: (5) CPG accessibility and ease of use; (6) endorsement and dissemination of CPGs and adequate access to treatment facilities and resources; (7) awareness of CPGs and belief in their relevance; and (8) belief that CPGs support decision making, improve patient care, reduce clinical variation, and reduce costs.

conclusionThese results highlight that adherence to active cancer treatment CPG recommendations by oncology clinicians is influenced by multiple factors such as attitudes, practices, and access to resources. The review has also revealed many similarities and differences in the factors associated with general CPG, and active cancer treatment CPG, adherence. These findings will inform tailored implementation strategies to increase adherence to cancer treatment CPGs.

trial registrationPROSPERO (2019) CRD42019125748.

Indexed as

Attitude of Health PersonnelPractice Guidelines as TopicDelivery of Health CareGuideline AdherenceHumansInformation DisseminationNeoplasmsOrganizational CultureClinical Practice GuidelinesEvidence-based practiceGuideline adherent treatmentImplementation ScienceOncology

Identifiers

PMID32460797
PMCPMC7251711
OpenAlexW3030566389

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.