In-depth assessment of Iraqi physicians' adherence to treatment guidelines for different diseases: a qualitative study

<ns3:p>Background In healthcare settings, specialists from different fields may follow the most well-known, reliable, and easy-to-understand medical guidelines. This study aimed to determine Iraqi physicians’ adherence to treatment guidelines, to specify which treatment guidelines are utilized for each disease and identify their barriers to follow the guidelines. Methods This was qualitative study including face-to-face interviews with specialist physicians from different disciplines. The interviews were conducted between December 2021 and May 2022 in Kirkuk province, Iraq. The qualitative data generated through interviews was analyzed using thematic analysis. Result The study recruited 48 specialists (27 male and 21 female) from seven medical specialties at two large government hospitals. Most physicians 38 out of 48 (79%) revealed that healthcare settings implement treatment guidelines in more than half of cases. American guideline was the most used among the participating physicians. European and British guidelines and textbooks were also used by some specialties. Unfortunately, most 43 out of 48 (89%) physicians were unaware of Iraqi treatment guideline. Most specialist physicians tended to follow the same international guideline within their respective specialties, exhibiting minimal variation in approach. Their adherence was largely shaped by clinical experience and individual flexibility. Nearly all participating physicians identified key barriers to guideline implementation, including shortages in treatment supplies (46 out of 48; 95%), investigation and laboratory materials (45 out of 48; 93%), and low patient adherence (44 out of 48; 91%). Six out of seven specialties experienced shortage in the essential medications that recommended by the guidelines. Conclusions This study highlights systemic and informational barriers to guideline adherence among Iraqi specialists. Addressing these gaps through targeted dissemination and resource allocation may improve clinical consistency and patient outcomes. Enhancing physician awareness of the Iraqi guidelines should be encouraged. Finally, securing essential medicines in public hospitals is pivotal to adopt evidence-based guidelines effectively.</ns3:p>