Asthma and chronic obstructive pulmonary disease (COPD) are
the two most common chronic pulmonary ailments in Canada,
affecting approximately 2.5 million and 750,000 individuals, respectively
(1). In the past two decades, the Canadian Thoracic Society has
successfully developed and disseminated evidence-based asthma and
COPD clinical practice guidelines; however, evidence suggests that
guideline implementation for these diseases remains inadequate (2,3).
Successful guideline implementation requires tailoring of selected
strategies to settings and population-specific barriers based on established
theories and principles (4,5). In 2004, the Canadian Thoracic
Society and its collaborators organized a symposium in Quebec City
(Quebec) to discuss existing barriers to respiratory guideline implementation
and possible knowledge translation (KT) strategies (3).
This was followed by an expert-led workshop on guideline implementation
strategies in autumn 2007.
Herein, we report the planned methods and outcome of a project
that resulted from these meetings. The present study sought to explore
the effectiveness of a multifaceted KT strategy in improving concordance
with COPD and asthma guidelines among primary care physicians
(PCPs) in Canada, but was aborted due to inadequate PCP
recruitment. We discuss the difficulties encountered in recruiting
PCPs, factors that may have influenced recruitment and alternative
strategies. Our goal is to provide practical lessons to inform the design