LOCAL-IMPACT OF THE NHMRC EARLY BREAST-CANCER GUIDELINES - WHERE TO FROM HERE

Objectives: To determine clinicians' recall of the National Health and Medical Research Council's (NHMRC) Clinical practice guidelines for t he management of early breast cancer six months after publication, and their reactions to its content and potential dissemination and implem entation strategies. Setting: Greater Western Region of Sydney, May 19 96. Method: Self-administered survey of clinicians with an involvement or interest in the management of women with breast cancer. Results: O f the 69 respondents to the questionnaire (77% response rate), 20% did not recall ever seeing the guidelines. Although most agreed with the defined parameters of potential strengths of the guidelines, there was less agreement as to their medicolegal implications. The four treatme nt sections of the guidelines were the most highly rated, followed by the sections on communication skills and investigations. Education pro grams, including college-based programs, as well as endorsement of the guidelines by the learned colleges and respected colleagues, were rat ed highly as dissemination strategies, far outranking Internet availab ility. Local revision of the guidelines was considered important as an implementation strategy by three-quarters of respondents. Only 20% in dicated that the guidelines had influenced clinical practice, although 46% agreed that they would improve outcomes for women with early brea st cancer. Conclusions: The NHMRC early breast cancer guidelines have been relatively well received in the Greater Western Region of Sydney, although local activities within public institutions and private prac tice will be needed to achieve implementation.