Clinical practice guidelines: Qualitative study of their implementation in the Chilean health system Guías de práctica clínica: Estudio cualitativo sobre su implementación en el sistema de salud de Chile

Abstract

Objective. Characterize the implementation process, barriers, and facilitators of evidence-based recommendations in the context of developing clinical practice guidelines (CPGs) generated by the Ministry of Health of Chile, in order to make proposals to optimize the process. Methods. Qualitative "action-oriented research" study. Nineteen semi-structured interviews were conducted and nine discussion groups were organized at various levels of the Chilean public health system. The analysis was conducted using Atlas.ti® software and manually, in a content analysis framework, by categorizing and coding information according to pre-specified dimensions and with the inclusion of emerging categories where relevant. Results. The main challenge mentioned with regard to implementing recommendations is the lack of an explicit and structured process. Actors in the health system recognize difficulties specific to the context in which the recommendations are followed. In this unprecedented instit