Background and Aims: European Society of Gastrointestinal Endoscopy guidelines aim to standardize endoscopic care, yet their daily use and implementation barriers are not fully understood. This study assessed ESGE guideline use patterns, perceived barriers, and preferred implementation strategies among Spanish endoscopists. Material and Methods: A national, cross-sectional, web-based survey targeted all members of the Spanish Society of Gastrointestinal Endoscopy. The questionnaire explored guideline use, perceived usefulness, implementation barriers (categorized by a structured framework), and potential implementation measures. Exploratory multivariable logistic regression analyses were performed to identify factors associated with guideline use. Results: A total of 114 endoscopists completed the survey (11%). ESGE guidelines were frequently used, especially for specific clinical questions (93%), and deemed more useful than unstructured sources (e.g., Google, commercial representatives). Multivariable analysis showed that increasing age was significantly associated with lower odds of frequent clinical guideline use (OR 0.91, 95%CI 0.86-0.97). Barriers concerning awareness or access were uncommon. Internal barriers, including guideline complexity (36.0%), perceived weak evidence (20.2%), and language (19.3%), were frequently reported. Environmental barriers, such as limited feasibility of implementing recommendations in local settings (33.3%), were also common. Digital point-of-care tools (94.7%) and improved web-based search functions (89.5%) were most supported implementation measures. Conclusions: Spanish endoscopists widely value and frequently use ESGE guidelines. Primary implementation barriers relate to guideline format, language, and local feasibility, not lack of agreement. Targeted improvements in guideline design and dissemination can enhance uptake in routine endoscopic practice.
Bustamante-Balén et al. (2026) studied this question.