Dissemination mechanisms of Clinical Practice Guidelines – Mixed methods evidence synthesis

Article type
Authors
Kumbargere Nagraj S1, Delvaux N2, Lubelwana Hafver T3, Hohlfeld A4, Effa E5, Mabetha D6, Kunje G7, Jiao Shen Y8, Zaror C9, Lakudzala S10, Mpando T11, van de Velde S3, Agoritsas T3, Vandvik P3
1Magic Evidence Ecosystem Foundation, OSLO, Norway; University of Plymouth, Plymouth, Devon, United Kingdom
2Katholieke Universiteit Leuven, Belgium
3Magic Evidence Ecosystem Foundation, OSLO, Norway
4Research Fellow, Centre for Evidence-Based Health Care, Stellenbosch University, South Africa
5Senior Lecturer, Internal Medicine at the College of Medical Sciences of the University of Calabar., Nigeria
6Senior Scientist, South African Medical Research Council, Health Systems Research Unit, South Africa
7Lecturer, Lilongwe University, Malawi
8Innovation Institute for Integration of Medicine and Engineering, Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
9Associate Professor, Center for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Faculty of Dentistry, Universidad de La Frontera, Chile
10Senior Research Scientist, Kamuzu University of Health Sciences, Malawi
11Researcher, Kamuzu University of Health Sciences, Malawi
Abstract
Background: Clinical practice guidelines (CPGs) are disseminated in various formats through different channels. However, end users might have diverse needs with regards to access and comprehension of CPGs and recommendations. Although many organisations present their CPGs as (often lengthy) documents, this format is not always well received by busy health care professionals. Increasingly, CPGs are digitally developed and structured, allowing for various dissemination formats and products. These different formats and products may include more abridged versions of a CPG, distributed through a variety of channels such as email, newsletters, social media, or academic journals. However, little is known on how these dissemination channels, formats and products (collectively termed as dissemination mechanisms) are received and perceived by end users or how they impact uptake.

Objectives: We conducted a systematic review to identify documented dissemination mechanisms for CPGs, barriers and facilitators to their access, and the expectations of end users regarding dissemination needs.

Methods: We searched MEDLINE, Embase, CINAHL, Web of Science, Scopus, Epistemonikos, Agency for Healthcare Research and Quality and Medical Guidelines Clearing house. We used the Critical Appraisal Skills Programme (CASP) Qualitative Studies Checklist to assess the quality of included studies. We followed interweaving approach for this mixed methods evidence synthesis. From the qualitative studies, we will use content analysis method for the first objective and thematic analysis for the latter two objectives. For the quantitative studies, we will present the data as descriptive statistics.

Results: We obtained 28,596 titles/abstracts and after deduplication, five pairs of reviewers screened the 6,523 titles/abstracts and 406 full text articles. We did purposive sampling to select a total of 50 qualitative studies based on the review objectives. We will present the results for the documented CPG dissemination formats, products and channels in table format. We will analyse the barriers and facilitators as themes. This is an ongoing systematic review and we anticipate to complete this review by July 2024.

Conclusions: We anticipate that this mixed-methods systematic review will highlight the various mechanisms of dissemination of CPGs and the associated barriers and facilitators.