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. 2009 Jul 2:4:36.
doi: 10.1186/1748-5908-4-36.

An exploration of how guideline developer capacity and guideline implementability influence implementation and adoption: study protocol

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An exploration of how guideline developer capacity and guideline implementability influence implementation and adoption: study protocol

Anna R Gagliardi et al. Implement Sci. .

Abstract

Background: Practice guidelines can improve health care delivery and outcomes but several issues challenge guideline adoption, including their intrinsic attributes, and whether and how they are implemented. It appears that guideline format may influence accessibility and ease of use, which may overcome attitudinal barriers of guideline adoption, and appear to be important to all stakeholders. Guideline content may facilitate various forms of decision making about guideline adoption relevant to different stakeholders. Knowledge and attitudes about, and incentives and capacity for implementation on the part of guideline sponsors may influence whether and how they develop guidelines containing these features, and undertake implementation. Examination of these issues may yield opportunities to improve guideline adoption.

Methods: The attributes hypothesized to facilitate adoption will be expanded by thematic analysis, and quantitative and qualitative summary of the content of international guidelines for two primary care (diabetes, hypertension) and institutional care (chronic ulcer, chronic heart failure) topics. Factors that influence whether and how guidelines are implemented will be explored by qualitative analysis of interviews with individuals affiliated with guideline sponsoring agencies.

Discussion: Previous research examined guideline implementation by measuring rates of compliance with recommendations or associated outcomes, but this produced little insight on how the products themselves, or their implementation, could be improved. This research will establish a theoretical basis upon which to conduct experimental studies to compare the cost-effectiveness of interventions that enhance guideline development and implementation capacity. Such studies could first examine short-term outcomes predictive of guideline utilization, such as recall, attitude toward, confidence in, and adoption intention. If successful, then long-term objective outcomes reflecting the adoption of processes and associated patient care outcomes could be evaluated.

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Figures

Figure 1
Figure 1
Conceptual framework of factors influencing guideline development, implementation and adoption.

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References

    1. Grimshaw J, Eccles M, Thomas R, MacLennan G, Ramsay C, Fraser C, Vale L. Toward evidence-based quality improvement. Evidence (and its limitations) of the effectiveness of guideline dissemination and implementation strategies 1966–1998. J Gen Intern Med. 2006;21(Suppl 2):S14–20. - PMC - PubMed
    1. Browman GP, Levine MN, Mohide A, Hayward RSA, Pritchard KI, Gafni A, Laupacis A. The practice guidelines development cycle: A conceptual tool for practice guidelines development and implementation. J Clin Oncol. 1995;13:502–512. - PubMed
    1. McGlynn EA, Asch SM, Adams J, Keesey J, Hicks J, DeCristofaro A, Kerr EA. The quality of health care delivered to adults in the United States. N Engl J Med. 2003;348:2635–2645. doi: 10.1056/NEJMsa022615. - DOI - PubMed
    1. FitzGerald JM, Boulet LP, McIvor RA, Zimmerman S, Chapman KR. Asthma control in Canada remains suboptimal: the Reality of Asthma Control (TRAC) study. Can Respir J. 2006;13:253–259. - PMC - PubMed
    1. Brown LC, Johnson JA, Majumdar SR, Tsuyuki RT, McAlister FA. Evidence of suboptimal management of cardiovascular risk in patients with type 2 diabetes mellitus and symptomatic atherosclerosis. CMAJ. . 2004;171(10):1189–1192. doi: 10.1503/cmaj.1031965. - DOI - PMC - PubMed

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