Introduction/Objective: To identify rigorous evaluations of the effectiveness of clinical practice guidelines in the following health professions: nursing, midwifery, podiatry, speech and language therapy, physiotherapy, occupational therapy, dietetics, clinical psychology, pharmacy, radiography; to synthesise the evidence for the effectiveness and cost-effectiveness of clinical practice guidelines as strategies for promoting improved practice in these professions.

Methods: Guideline evaluations conducted since 1975 which used a randomised controlled trial, controlled before-and-after, or interrupted time series design, were identified using a combination of handsearching and database searching. Each eligible study was assessed for methodological quality and data extracted by two reviewers working independently, using the instruments developed by the Cochrane Collaboration Effective Professional Practice Review Group (CCEPP).

Results: Whilst we identified hundreds of publications describing guideline development in these professions, very few proceeded to evaluate their impact. Fewer than 20 eligible evaluations have been identified and these are of varying quality. The effect of clinical practice guidelines on professional performance and patient outcomes is variable with some studies indicating a positive effect. Importantly, few of the many guidelines developed, and even of those evaluated, were evidence-based.

Discussion: A previous systematic review has demonstrated that clinical guidelines can influence medical practice, and that if they are rigorously developed and consistent with current evidence, they can lead to health gain. Whilst there is some (weak) evidence that guidelines can influence the practice of other health professions, few of the guidelines evaluated have been based on summaries of the best available evidence.