Article type
Year
Abstract
Background: There are various interventions for guideline implementation in clinical practice, but the effects of these interventions are generally unclear. There is a plethora of primary research evidence about the effectiveness of these interventions however it is dispersed amongst medical literature.
Objectives: We conducted a systematic review to identify the most effective methods of implementing clinical research findings and clinical guidelines to change physician practice patterns, in surgical and general practice. Additional focus was placed on presenting research findings on long-term effects and cost effectiveness of the implementation methods.
Methods: We searched electronic databases (including MEDLINE, EMBASE, and PubMed) for systematic reviews published in English, which evaluated the effectiveness of different implementation methods. Two reviewers independently assessed methodological quality and extracted relevant data from the reviews.
Results: Eighteen reviews were identified covering a wide range of interventions. In general, passive approaches are ineffective and unlikely to create physician behaviour change. Most other interventions were relatively more effective when used as multifaceted interventions, compared to single interventions. Overall, continuing medical education was most effective in changing physician practice pattern.
Conclusions: Continuing medical education and multifaceted interventions are the most effective implementation methods. Additionally active approaches to changing physician performance are shown to improve practice to a greater extent than traditional passive methods. Further primary research is necessary to inform the effectiveness of these methods specific to surgical settings, their cost-effectiveness and long-term effects.
Objectives: We conducted a systematic review to identify the most effective methods of implementing clinical research findings and clinical guidelines to change physician practice patterns, in surgical and general practice. Additional focus was placed on presenting research findings on long-term effects and cost effectiveness of the implementation methods.
Methods: We searched electronic databases (including MEDLINE, EMBASE, and PubMed) for systematic reviews published in English, which evaluated the effectiveness of different implementation methods. Two reviewers independently assessed methodological quality and extracted relevant data from the reviews.
Results: Eighteen reviews were identified covering a wide range of interventions. In general, passive approaches are ineffective and unlikely to create physician behaviour change. Most other interventions were relatively more effective when used as multifaceted interventions, compared to single interventions. Overall, continuing medical education was most effective in changing physician practice pattern.
Conclusions: Continuing medical education and multifaceted interventions are the most effective implementation methods. Additionally active approaches to changing physician performance are shown to improve practice to a greater extent than traditional passive methods. Further primary research is necessary to inform the effectiveness of these methods specific to surgical settings, their cost-effectiveness and long-term effects.
