CLINICAL GUIDELINES - THEIR IMPLEMENTATION IN GENERAL-PRACTICE

In recent years the development of clinical guidelines has received in creasing attention from medical educators and those involved in standa rd setting, and has been initiated at both central and local levels. T his review article outlines the current state of knowledge with regard to clinical guideline implementation in medical practice. It deals wi th the main aspects of the current guideline debate, such as, clinical freedom and doctor autonomy, the importance of ownership in guideline implementation, the effectiveness of guidelines in changing practice and, in particular, the strategies needed to implement clinical guidel ines in general practice. Mechanisms of behavioural change that have b een recognized as being important for implementation are also discusse d. If implementation strategies are not treated as an integral part of the development process then clinical guidelines may fail to achieve their potential in changing clinical practice.