Survey on Clinical Practice Guidelines Use among Latin American Cardiologists.

Mariano A. Giorgi, Raúl A. Borracci, Gustavo Calderón, Diego Manente, Andrés Mulassi, Daniel J. Piñeiro, Wistremundo Dones



There is a broad consensus about the benefits of applying

Clinical Practice Guidelines (CPGs) as a standard of care

and most countries, even in Latin America; however, the

applicability of CPGs to medical practice is lower than expected.

The failure in the implementation of CPGs is due

to several factors, including physicians’ lack of adherence.


To estimate the utilization rate of CPGs and to know the

objections of Latin American cardiologists against them.

Material and Methods

We conducted an anonymous email survey among 10% of the

Spanish-speaking members of the Interamerican Society

of Cardiology that were randomly selected. The questions

included demographic data, use of CPGs and objections to

use them. We assumed that most of the respondents would

make a positive answer when asked about the use CPGs;

yet, we also assumed that they would criticize and comment

the limitations of CPGs if they were induced to do so.


The survey was responded by 952 of the 1197 cardiologists

selected. The utilization rate of CPGs was 91.5%; 75.8%

(660/871) used foreign and local guidelines, while 24.2%

only used local CPGs. 58.2% of survey respondents had at

least one objection to the quality or usefulness of CPGs. The

most common complaints were that the guidelines proposed

the use of resources that were not always available (11.5%),

recommended impractical strategies due to lack of medical

coverage (9.2%) and did not represent the patients in real

practice (7.7%). Among those who did not use CPGs, 22.2%

did not know the last guidelines published.


Although the utilization of CPGs is high, the objections

about their usefulness constitute a barrier to improve the

adherence of cardiologists to use them. These data should

be considered to improve the production, diffusion and

implementation of CPGs in Latin America.

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Revista argentina de cardiología. ISSN en línea 1850-3748. Argentine journal of cardiology (English ed. Online ISSN 2314-2286) Sociedad Argentina de Cardiología. Azcuénaga 980 (C1115AAD),Ciudad Autónoma de Buenos Aires, República Argentina. Tel. (54 11) 4961-6027/8/9 Fax: 4961-6020