Clinical practice guidelines and Australian general practice. Contemporary issues.

BACKGROUND: This paper summarises recent important clinical practice guideline initiatives in Australia which have direct relevance to Australian general practice.
OBJECTIVE: Activities of the National Health and Medical Research Council (NH&MRC), professional groups and the Commonwealth Department of Health's General Practice Strategy including relevant outputs of the General Practice Evaluation Program are examined in detail. This paper provides criteria for GPs to assess whether a clinical practice guideline is likely to be practical and useful for them. It examines the future development of guidelines and emphasises the need for a clearer understanding of the GP role in this and highlights strategies for overcoming barriers to implementation. DISCUSSION: While a great deal of effort has been invested in clinical practice guideline development and implementation, further development and focussed effort on dissemination is needed if they are to fulfill their potential to improve clinical practice. Australian general practice presents a number of challenges and barriers to successful uptake including lack of computerisation, attitudinal barriers and variable coverage of clinical issues in existing guidelines. Concern about the nature and purpose of guidelines is also frequently expressed.