Background: Clinical guidelines are known as an effective way to improve health performance. However, little is known about general practitioners’ attitudes to and behaviours concerning clinical guidelines in China.

Objectives: The aim of this study is to investigate use behaviours and needs of clinical guideline in primary care of China.

Methods: We conducted a cross-sectional survey among 268 institutions in 15 provinces of China from December 2015 to May 2016. The questionnaire was developed by literature review and experts consultation method. On-site survey was performed by paper questionnaires to minimise response missing. Multivariate logistic regression was used to identify factors associated with the knowledge of and attitude towards clinical guidelines.

Results: Among respondents, 91.7%(1568/1708) knew clinical guidelines but only 11.3%(177/1568) frequently use them. The main access to guidelines for primary-care practitioners was public search engines (63.4%;911/1438) instead of biomedical database and the major barriers for primary-care practitioners to use guidelines included lack of training (49.9%;778/1560), access (44.6%;696/1560) and awareness (38.0%;592/1560). Only less than ¼ of respondents considered current guidelines were ‘entirely appropriate’ for primary-care setting (23.5%;339/1442). Most participants (96.2%;1509/1568) admitted the necessity of developing clinical guidelines for primary care. The attitude towards current guideline was associated with institutions’ location, level, and professional title (P<0.05).

Conclusions: Our survey reveals poor knowledge and use of clinical guidelines in primary care as well as the gap between the needs and current status of clinical guidelines for primary care in China. In addition, lack of access to and training in the development of guidelines also prevent primary healthcare practitioners from using guidelines in their daily practice.