How can the implementation of guidelines be improved?

Guidelines for a variety of diseases have now been produced. However, imple mentation of guidelines requires that the medical profession is willing to conform to patterns of diagnostic and treatment behavior set down by others . This may not happen in practice. Early experience in the United Kingdom w as gained with the introduction of guidelines for the management of asthma. For a number of years, there have been improvements in practice, but defic iencies still exist. When the introduction of guidelines for the management of COPD was planned, a new approach was taken with a consortium of the Bri tish Thoracic Society, pharmaceutical companies, and medical equipment comp anies being formed to promote their use. Early studies show that COPD care starts from an even lower baseline than asthma; there is poor understanding of objective diagnosis of COPD in both primary and secondary care.