Researchers interviewed 16 Australian MS clinicians (10 MS nurses, 6 neurologists) about their use of clinical practice guidelines for multiple sclerosis.
Most clinicians believed guidelines improve consistency, safety, and quality of care, but reported great variation in actual use. Clinicians combined guideline recommendations with clinical judgment, patient circumstances, MS complexity, and access to care factors.
Barriers to Guideline Use
- Lack of awareness or familiarity with existing guidelines
- Guidelines perceived as too complex or hard to navigate
- Difficulty accessing guidelines (e.g., behind paywalls or requiring logins)
- Time pressures and staff shortages making compliance difficult
- Concerns about evidence strength and credibility of guidelines
Facilitators and Suggested Improvements
- Guidelines should be relevant to local organizational needs, clear, credible, and up-to-date.
- Improve awareness and distribution through communication and education channels.
- Update guidelines regularly to reflect latest evidence.
- Ensure applicability and adaptability to local clinical situations.
- Enhance access (e.g., centralized library, patient versions).
- Make guidelines user-friendly with brief formats, flowcharts, checklists, and take-home messages.
- Strengthen credibility through endorsement by professional organizations and senior clinicians.
Varying treatment quality for people with MS across Australia could be addressed by increased guideline use.
Implications
The study identifies ways to make guidelines easier for clinicians to find and use, aiming to improve consistency and quality of care.