Article
Perceived barriers on good quality of hospital care for patients with non-Hodgkin's lymphoma: a survey study among patients and medical specialists
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Published: | July 10, 2012 |
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Background: Quality indicators have been developed to measure guideline adherence for patients with non-Hodgkin's lymphoma (NHL). Most of these indicators showed room for improvement. A first step towards improving guideline adherence is getting insight into factors influencing this adherence.
Objectives: This study aims to identify barriers that influence guideline adherence and quality of care for NHL-patients.
Methods: A quantitative, web-based survey was conducted among specialists involved in NHL-care and patients with NHL. Participants were asked about the barriers influencing clinical practice regarding NHL-care. The factors identified were classified into five domains: factors related to the guideline (I), characteristics of professionals (II) and patients (III) and factors concerning organizational (IV) and social context (V).
Results: Barriers were perceived in all domains. Most important barriers identified by specialists (n=132) concerned the poor (online) availability of the guideline (I) and the absence of multidisciplinary meetings with all specialists involved (V). Patients (n=28) perceived a lack of clear information and communication about diagnostics, treatment options and possible side effects (II) as barriers.
Discussion: These barriers can be used to develop a tailored implementation strategy to optimize guideline adherence and NHL-care in daily practice. A clinical trial to test these strategies is the next step towards improving the quality of NHL-care in the future.
Implications for guideline developers/users: Guideline developers, specialists and patients should take into account that guideline development alone does not ensure good quality of NHL-care. Tailored implementation of the guideline will help to facilitate this.