ShEAFS Sifting the wheat from the chaff Review of impact of clinical guidelines on clinical outcomes in primary care shows little evidence of effectiveness Problem General practitioners overwhelmed by volume and variable quality of guidelines.
Considerable barriers exist to implementation of guidelines in primary care.
However demonstrating that guidelines in primary care impact positively on patient outcome might prove useful in overcoming GP resistance to guidelines. Of 91 trials only 13 met the inclusion criteria for more detailed appraisal. Four of the studies followed nationally developed guidelines and 9 used locally developed guidelines. Six involved computerised reminder systems whereas the rest relied on small-group workshops and education sessions. Review not focused with regard to population , interventions or outcomes .