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Table 4 Facilitators and barriers of guideline implementability as perceived by Family Physicians: LANGUAGE

From: The development of a guideline implementability tool (GUIDE-IT): a qualitative study of family physician perspectives

Facilitators (Number of respondents) Utterance example Barriers (Number of respondents) Utterance example
Clarity (N = 18)
Clear (N = 6) Guidelines need to be clear {I-6} Language too dense or detailed (N = 8) When it comes to wording of recommendations, if there is too much information in a single recommendation, the reader gets lost in it. {I-5}
Easy to read and understand (N = 2) Guidelines need to be easy to read and understand {I-6} Difficult to understand (N = 1) If recommendation is hard to understand, I just glaze over it {I-2}
Specificity (N = 11)
Specific (N = 7) Guidelines need to be as specific as possible to the question {I-2} Guideline vague (N = 4) If the guideline is vague, if for example 2 medications fits all approaches then I find that not very useful {I-3}
Actionability (N = 7)
Doable and directive (N = 3) It should guide the questions that you are asking and get you to the decision making point in the guideline; Guidelines should direct me through the end stages of management and diagnostic processes so it gets to the bottom line recommendations {I-1} Vague about what to do (N = 2) Often the actual recommendation does not answer the question – it may give you a direction but you may need to dig deeper to find out how to actually carry out the recommendation {I-5}
  Having clear cut instructions (N = 1) If you pushed for time or you have extenuating circumstances or a, a visit includes parents or other informants that may have different ideas you eliminate the distractibility of not completing the information you do need by having clear cut instructions as to what should be included. {I-2}
Should be comprehensive (N = 1) Something that's comprehensive so that if you’re pushed for time or you have extenuating circumstances or a visit includes parents or other informants that may have different ideas you eliminate the distractibility and have clear cut instructions as to what should be included {I-2}.
Sensibility (N = 3)
  It has to make sense (N = 2) It has to make sense, whatever the new thing is. So often the guideline comes out and I will often sit back and say, I don't think this really makes sense, and it doesn't resonate with me, like HRT. {I-6} Not having guidelines in other languages (N = 1) One barrier may be language, not having things available in the language of the physician or patient. Some of the materials need to be filled in by the patients as well and if they don't understand the date of last pap smear was, then the information is going to have limited use {I-2}
Guidelines need to be intuitive and logical {FG4-P2}.