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Review on Factors Influencing Physician Guideline Adherence in Cardiology

Hoorn, C.J.G.M., MSc*; Crijns, H.J.G.M., MD, PhD; Dierick-van Daele, A.T.M., MSc, PhD; Dekker, L.R.C., MD, PhD*

doi: 10.1097/CRD.0000000000000207
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Cardiovascular disease is the most common cause of death in Western countries. Physician adherence to guidelines is often suboptimal, resulting in impaired patient outcome and prognosis. Multiple studies have been conducted to evaluate patterns and the influencing factors of patient adherence, but little is known about factors influencing physician guideline adherence. This review aims to identify factors influencing physician guideline adherence relevant to cardiology and to provide insights and suggestions for future improvement. Physician adherence was measured as adherence to standard local medical practice and applicable guidelines. Female gender and older age had a negative effect on physician guideline adherence. In addition, independent of the type of heart disease, physicians without cardiologic specialization were linked to physician noncompliance. Also, guideline adherence in primary care centers was at a lower level compared with secondary or tertiary care centers. The importance of guideline adherence increases as patients age, and complex diseases and comorbidity arise. Appropriate resources and interventions, taking important factors for nonadherence in account, are necessary to improve guideline adoption and adherence in every level of the chain. This in turn should improve patient outcome.

From the *Department of Cardiology, Catharina Hospital Eindhoven

Department of Cardiology, Maastricht University Medical Centre

Department of Education and Research, Catharina Hospital Eindhoven, The Netherlands.

Disclosure: The authors declare no conflict of interest.

Supported by Netherlands Heart Network, which is greatly appreciated.

Correspondence: C.J.G.M. Hoorn, Msc, Department of Cardiology, Catharina Hospital Eindhoven, P.O. Box 1350, 5602 ZA Eindhoven, The Netherlands. E-mail: cassandra.hoorn@catharinaziekenhuis.nl.

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