Physicians' Perspectives of the Factors Influential in Implementing National Clinical Guidelines for Hypertension in Iran: A Qualitative Study

• Main Authors: Alireza Khosravi (Author), Mousa Alavi (Author), Maryam Eghbali Babadi (Author), Mohsen Shahriari (Author), Razieh Molavi (Author), Azam Mahmoodi (Author), Mandy.M. Archibald (Author)
• Format: Book
• Published: Zanjan University of Medical Sciences and Health Services, 2021-12-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.52547/pcnm.11.4.55; 2588-4441; 2588-445X
• Keywords: hypertension; preventive care; clinical practice guideline; facilitators; barriers; physicians; Nursing; RT1-120
• Source: Preventive Care in Nursing and Midwifery Journal, Vol 11, Iss 4, Pp 55-62 (2021)

Background: Although clinical guidelines help in the prevention, diagnosis, and management of hypertension, individuals with hypertension often remain undiagnosed, or once diagnosed, may not receive adequate care and treatment. Objectives: In this study, we explored physicians' perspectives of the factors influential in implementing the Iranian Recommendations on Prevention, Evaluation, and Management of Hypertension (IRPEM-HTN). Methods: A qualitative descriptive study was conducted using the purposeful sampling method to enroll 30 physicians from October 2016 to May 2018. The physicians working in private offices or university-affiliated health centers/hospitals in the province of Isfahan, Iran, were included in this study one year after participating in the IRPEM-HTN program. The data were gathered through semi-structured interv iews. The transcribed data were thematically analyzed, and the rigor was ensured following the procedure outlined by Braun and Clark. Results: This themes identified were: 1) macro- and meso-contextual factors, emphasizing that a) policies at all levels affect guideline adherence, and b) environmental-contextual factors affect guideline adherence, 2) micro level factors, emphasizing that c) attributes of the guideline affect guideline adherence, and d) clinician- and patient-level factors affect guideline adherence. Micro-, meso- and macro-level factors influenced guideline implementation. Conclusion: The attitudes, awareness, knowledge, and capacity of clinicians, as well as a broader socio-cultural context should be taken into account for guideline implementation.