Background The clinical practice guidelines (CPGs) of the National Health System of Mexico (NHSM) aim to improve the quality and to reduce the heterogeneity of medical care.

Objectives To assess the success of the implementation of the CPGs in medical units of the NHSM.

Methods 480 health units were randomly sampled. In each one, the following items were applied: a checklist in order to verify the existence of CPGs, a questionnaire for physicians to document their knowledge, training and awareness on CPGs, and another one to those in charge of the dissemination and implementation process. Clinical records were reviewed to document the use of CPGs.

Results The diffusion of the CPGs is conducted via internet through the Master Catalogue (MC). The MC was identified in 80% of the sample. The overall level of training on CPGs was 56% (45% -100%). 88% of doctors are aware of the existence of CPGs and 71% reported the utilisation of a CPG during the last month. 30% of the people in charge of dissemination do not have the necessary resources for the dissemination and implementation. The adherence level falls below 50%.

Discussion One limitation to the dissemination of the CPG is internet access, along with training variability among institutions. The main barrier to the use of CPGs, is the lack of resources (physical material, human and time) for the dissemination and implementation.

Implications for Guideline Developers/Users The knowledge of CPGs is high, however there are barriers that limit their implementation.