Screening guidelines for Chlamydia trachomatis infection. Evaluating physician awareness, agreement, and use.
OBJECTIVE
To assess whether physicians were aware of, agreed with, and followed the "1989 Canadian Guidelines for Screening for Chlamydia Trachomatis Infection "as they applied to screening asymptomatic women.


DESIGN
A survey consisting of direct questions and case scenarios was scored according to the responses given in the guidelines.


SETTING
Six hospital family practice teaching units in downtown Toronto.


PARTICIPANTS
Of 153 staff physicians and residents surveyed (all staff and residents registered with the Department of Family and Community Medicine of the University of Toronto for the 1990-1991 academic year), a volunteer sample of 118 responded to a questionnaire through the mail.


MAIN OUTCOME MEASURES
Reported awareness, agreement, and use of C trachomatis guidelines for screening asymptomatic women were analyzed using frequency distributions and cross-tabulations.


RESULTS
Most (69%) respondents were unaware of the guidelines. Of those who were aware, 46% agreed with the guidelines and 39% claimed to follow the guidelines. Staff physicians appeared to be more aware of guidelines than family medicine residents (P = 0.0175, psi 2 = 11.98); P values less than 0.05 were considered statistically significant. There was no statistically significant association between total scores and physicians' reported awareness of guidelines (P = 0.2287, psi 2 = 4.321).


CONCLUSIONS
Most physicians in the sample were unaware of the guidelines. Of physicians who reported awareness of the guidelines, less than half agreed with or routinely followed them. Better methods of influencing physician behaviour must be developed before more guidelines are designed and distributed.