Objective
Chronic noncommunicable diseases are the leading cause of death and disability worldwide, with devastating effects on household economies and national growth. The objective of this research is to investigate the knowledge and application of clinical practice guidelines in primary care in Argentina, and to identify barriers and facilitators in the use of evidence-based practices for diagnosis, access, and adherence to noncommunicable disease prevention and control.
Methods
Descriptive quantitative-qualitative study. In the quantitative phase, a survey of trained professionals was conducted in 2020 and 2021. In the qualitative phase, semi-structured interviews were conducted with health professionals and managers between July and December 2021.
Results
The response rate was 29%. Among professionals with a care function, 81% reported knowledge of the guidelines (the most well-known were those for hypertension and diabetes), although the implementation rate varied. A full 83% considered their content clear, 70% found the guidelines appropriate for the setting, and 60% cited the scarcity of resources as an obstacle. The interviews revealed that the guidelines are not frequently followed and the existence of barriers to their implementation, such as organizational culture, lack of leadership, resistance to change, and the heterogeneity of teams. Facilitating factors included a comprehensive perspective and trainings.
Conclusions
The existence of guidelines is not sufficient to modify practices in health teams, since, while they are known, their adoption is limited. Interdisciplinary work and continuous in-service training tailored to the context are key facilitators. Local strategies, incentives, and specific resources need to be introduced in primary health care for effective implementation of the guidelines.