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There exists a variety of physician barriers to guideline adherence, for example, lack of awareness, lack of familiarity, lack of agreement, lack of outcome expectancy, or inertia of previous practices (Cabana et al, 1999).
For physicians to change their practices according to evidence-based guidelines, they must recognize, and understand, and agree with the evidence, feel confident about their abilities, and overcome the inertia of previous practices [ 24].
Barriers were classified into seven general categories: barriers affecting physician knowledge (lack of awareness and lack of familiarity); those affecting attitudes (lack of agreement, lack of self-efficacy, lack of outcome expectancy and the inertia of previous practices); and those affecting behavior (external barriers).
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It seems to us that the two main factors responsible are lack of familiarity and inertia of previous practice.
Furthermore, the history of an artform may include (as music did) an autographic stage, which only at a later time made room for the establishment of a notation, on the grounds of previous practice.
Physician adherence to guidelines may be hindered by a variety of barriers, which include lack of awareness, lack of familiarity, and lack of agreement with guidelines, lack of self-efficacy, lack of outcome expectancy, the inertia of previous practice, and external barriers.
One might churlishly point out that doubtlessly there were Douthats active in each of the epochs arguing that these radical transformations of previous practice granted forgiveness to those who, under the old standards, did not merit it.
This can be discussed as a remnant of previous practice when RADT was not used.
One possible explanation here, which is difficult to address further, is that this is a consequence of previous practice and local marketing practices.
Common reasons include lack of awareness, familiarity, and agreement, inertia of previous practice, and external barriers such as the guidelines being inconvenient, confusing, and cumbersome [ 1].
Thus, data will be collected to allow an assessment of previous practice patterns and determine any impact of the Hawthorne Effect.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com