The proportion of PTs reporting frequent guideline use after participation in the implementation seminar was 15.2% (p = 0.043) higher than the proportion in the control group.
The post-intervention rate of frequent guideline use in our study, 55%, can still be considered quite low, leaving room for future improvement.
Specific challenges identified that can impede delivery of consistent genetic care include the rapid evolution of the field, frequent guideline updates and insufficient funding available to enable successful and consistent implementation of guidelines into clinical practice nationally.
In BC, rates of VL measurement were even more frequent than guidelines suggest, with an average measurement frequency of almost five times annually.
These times were four weeks, 12 weeks, and 27 weeks for patients receiving excessive, frequent, and guideline recommended testing, respectively.
Frequent use of guidelines and supervision appeared to re-enforce adherence to the guidelines.
This difficulty might arise in part from the overly frequent revision of guidelines and the absence of a consensus on the target Hb level to aim for.
If these differences can be explained by a higher prevalence or a more frequent use of guidelines in the Australian clinical setting, or by different training or regulations between the countries, remains unknown and needs further study.
Yet one doctor argued that " in terms of diagnosis, full length of investigation, government hospitals are better because we have a strict protocol" (HP), although this was not supported by the evidence of frequent departures from guidelines.
Frequent revisions of guidelines, modifications of ESA's Summary of Product Characteristics (SPC) and concerns about the safety of ESAs raised by major clinical trials are gradually modifying practices.
