Abstract
Clinical guidelines can improve the quality and safety of health care by reducing inappropriate actions. However, the implementation of these documents is influenced by several factors. This study aimed to identify the barriers in the implementation of guidelines for early breast and cervical cancer detection in Brazil, as seen from the public health managers (SUS) perspective. This is a cross-sectional and exploratory research with quantitative-qualitative design, involving 60 managers. The implementation main barriers for breast cancer were: medical society conflicts (31.0%), low professionals’ adherence (20.7%); and disorganization of health services (17.2%). For the cervical cancer, these are: little organizational tradition in the use of guidelines (25.0%); low professionals’ adherence (21.4%); and disorganization of health services (21.4%). Other identified barriers were the precariousness of the information health system and high turnover of professionals. Regional differences stood out in the inappropriate demand of the population in the South Region and lack of financial resources in the North Region. The results reinforce the fact that inefficient communication does affect the medical practice. Moreover, the adherence of both professionals and users to recommendations are related to interdependent and synergistic conditions that become more relevant at the practical, systemic, and organizational dimensions.
Keywords:
early detection of cancer; guideline adherence; breast neoplasms; cervical cancer