What are the key barriers to the implementation of guideline recommendations for breast cancer survivors? Protocol of a mixed methods study

Abstract

The cancer survival rate has increased and family physicians (FPs) follow cancer survivors who experience long-term problems. Clinical practice guidelines outline best practices in cancer survivor care, but most FPs are unaware of this information. Little is known about specific barriers to survivorship guideline implementation in primary health care. Thus, our objectives are to identify patterns of FP non-use of survivorship guideline recommendations and describe key use-related barriers. The present paper reports a mixed methods study protocol that is implemented. Participants are FPs providing care to at least one breast cancer survivor. Quantitative component: Recommendations are integrated in a mobile application. Through this app, we deliver a weekly alert to one recommendation. FPs can rate recommendations using the validated Information Assessment Method (IAM) questionnaire. We will identify patterns of non-use of recommendations. Qualitative component: We will interview FPs who do not use a recommendation, identify use-related barriers, and assign them to themes related to information non-use. Integration: We will compare quantitative and qualitative results. We anticipate that results will identify unique barriers to implementation of survivorship information, as well as potential solutions and strategies to improve patient care, for example, information specialists producing and disseminating patient health information. Thus, finding barriers and solutions will contribute to the practice of informationists and FPs.