Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2012 Oct 17;10(10):CD004398.
doi: 10.1002/14651858.CD004398.pub3.

Printed educational materials: effects on professional practice and healthcare outcomes

Anik Giguère  1 , France Légaré, Jeremy Grimshaw, Stéphane Turcotte, Michelle Fiander, Agnes Grudniewicz, Sun Makosso-Kallyth, Fredric M Wolf, Anna P Farmer, Marie-Pierre Gagnon
Affiliations
Meta-Analysis

Printed educational materials: effects on professional practice and healthcare outcomes

Anik Giguère et al. Cochrane Database Syst Rev. .

Update in

Abstract

Background: Printed educational materials are widely used passive dissemination strategies to improve the quality of clinical practice and patient outcomes. Traditionally they are presented in paper formats such as monographs, publication in peer-reviewed journals and clinical guidelines.

Objectives: To assess the effect of printed educational materials on the practice of healthcare professionals and patient health outcomes.To explore the influence of some of the characteristics of the printed educational materials (e.g. source, content, format) on their effect on professional practice and patient outcomes.

Search methods: For this update, search strategies were rewritten and substantially changed from those published in the original review in order to refocus the search from published material to printed material and to expand terminology describing printed materials. Given the significant changes, all databases were searched from start date to June 2011. We searched: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), HealthStar, CINAHL, ERIC, CAB Abstracts, Global Health, and the EPOC Register.

Selection criteria: We included randomised controlled trials (RCTs), quasi-randomised trials, controlled before and after studies (CBAs) and interrupted time series (ITS) analyses that evaluated the impact of printed educational materials (PEMs) on healthcare professionals' practice or patient outcomes, or both. We included three types of comparisons: (1) PEM versus no intervention, (2) PEM versus single intervention, (3) multifaceted intervention where PEM is included versus multifaceted intervention without PEM. There was no language restriction. Any objective measure of professional practice (e.g. number of tests ordered, prescriptions for a particular drug), or patient health outcomes (e.g. blood pressure) were included.

Data collection and analysis: Two review authors undertook data extraction independently, and any disagreement was resolved by discussion among the review authors. For analyses, the included studies were grouped according to study design, type of outcome (professional practice or patient outcome, continuous or dichotomous) and type of comparison. For controlled trials, we reported the median effect size for each outcome within each study, the median effect size across outcomes for each study and the median of these effect sizes across studies. Where the data were available, we re-analysed the ITS studies and reported median differences in slope and in level for each outcome, across outcomes for each study, and then across studies. We categorised each PEM according to potential effects modifiers related to the source of the PEMs, the channel used for their delivery, their content, and their format.

Main results: The review includes 45 studies: 14 RCTs and 31 ITS studies. Almost all the included studies (44/45) compared the effectiveness of PEM to no intervention. One single study compared paper-based PEM to the same document delivered on CD-ROM. Based on seven RCTs and 54 outcomes, the median absolute risk difference in categorical practice outcomes was 0.02 when PEMs were compared to no intervention (range from 0 to +0.11). Based on three RCTs and eight outcomes, the median improvement in standardised mean difference for continuous profession practice outcomes was 0.13 when PEMs were compared to no intervention (range from -0.16 to +0.36). Only two RCTs and two ITS studies reported patient outcomes. In addition, we re-analysed 54 outcomes from 25 ITS studies, using time series regression and observed statistically significant improvement in level or in slope in 27 outcomes. From the ITS studies, we calculated improvements in professional practice outcomes across studies after PEM dissemination (standardised median change in level = 1.69). From the data gathered, we could not comment on which PEM characteristic influenced their effectiveness.

Authors' conclusions: The results of this review suggest that when used alone and compared to no intervention, PEMs may have a small beneficial effect on professional practice outcomes. There is insufficient information to reliably estimate the effect of PEMs on patient outcomes, and clinical significance of the observed effect sizes is not known. The effectiveness of PEMs compared to other interventions, or of PEMs as part of a multifaceted intervention, is uncertain.

PubMed Disclaimer

Conflict of interest statement

JG is author of one of the included studies.

Figures

1
1
Risk of bias summary: review authors' judgements about each risk of bias item for each included RCT study.
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included ITS study.
3
3
Potential effect modifier ‐ source of information. Legend: 1 = researchers/clinicians; 2 = university; 3 local expert body; 4 = national professional expert body; 5 = national government expert body; 6 = local clinicians; 7 = international expert body; 8 = international government expert body; 9 = unclear.
4
4
Potential effect modifier ‐ tailoring. Legend: 1 = tailored to individuals based on diagnostic, behavioural, or motivational characteristics; 2 = tailored to groups of individuals; 3 = personalised, but not tailored (person's name on the information); 4 = generic; 5 = unclear.
5
5
Potential effect modifier ‐ clinical area. Legend: ERT = Oestrogen‐replacement therapy.
6
6
Potential effect modifier ‐ type of targeted behaviour. Legend: 1 = prescribing/treatment; 2 = financial (resource use); 3 = general management of a problem; 4 = diagnosis; 5 = procedures; 6 = referrals; 7 = test ordering; 8 = surgery; 9 = patient education/advice; 10 = clinical prevention service; 11 = screening; 12 = reporting; 13 = professional‐patient communication; 14 = record keeping; 15 = discharge planning; 16 = unclear.
7
7
Potential effect modifier ‐ purpose. Legend: 1 = initiation of management (e.g. introduction of new technology); 2 = stopping introduction of new management; 3 = increase of established management; 4 = cessation of established management; 5 = reduction of established management; 6 = modification of management (e.g. increased management in one activity, reduction in another).
8
8
Potential effect modifier ‐ Level of evidence. Legend: 1 = system (computerised decision support); 2 = summaries (evidence‐based textbook); 3 = systematic review of RCTs; 4 = clinical practice guidelines developed through formal consensus process; 5 = other synthesis; 6 = original RCT; 7 = original studies not RCT; 8 = expert opinion; 9 = unclear.
9
9
Potential effect modifier ‐ format. Legend: 1 = publication of RCT results in peer‐reviewed journal; 2 = quick reference of clinical guidelines; 3 = full clinical guidelines; 4 = newsletter or bulletin; 5 = manual of peer‐reviewed clinical article reprints; 6 = other.
10
10
Potential effect modifier ‐ Mode of delivery. Legend: 1 = publication in peer‐reviewed journal; 2 = passive dissemination; 3 = direct mailing; 4 = mass mailing; 5 = media; 6 = hand delivery; 7 = unclear
11
11
Potential effect modifier ‐ frequency of delivery (once, twice, 3 times, more than 3 times, indeterminate).
12
12
Potential effect modifier ‐ duration of delivery (once, 1‐3 months, 4‐6 months, over 6 months, indeterminate).
13
13
Potential effect modifier ‐ endorsement (yes, no, unclear).
14
14
Potential effect modifier ‐ educational component. Legend: 1 = continuing professional development (CPD) credits to recipients of PEMs; 2 = PEM delivered within a formal education programme; 3 = clear statement in the study that the PEM is intended for education; 4 = no clear educational component.
15
15
Potential effect modifier ‐ appearance. Legend: 1 = black and white, with a few figures or tables; 2 = enhanced communication format (colour, picture, or figure); 3 = unclear.
16
16
Potential effect modifier ‐ endorsement (yes, no, unclear).
See this image and copyright information in PMC

Update of

References

References to studies included in this review

Austin 2003 {published data only}
    1. Austin PC, Mamdani MM, Tu K, Jaakkimainen L. Prescriptions for estrogen replacement therapy in Ontario before and after publication of the Women's Health Initiative Study. Journal of the American Medical Association. 2003/06/26 2003; Vol. 289, issue 24:3241‐2. - PubMed
Austin 2004A {published data only}
    1. Austin PC, Mamdani MM, Tu K. The impact of the Women's Health Initiative study on incident clonidine use in Ontario, Canada. Canadian Journal of Clinical Pharmacology 2004;11(2):e191‐4. - PubMed
Austin 2004B {published data only}
    1. Austin PC, Mamdani MM, Tu K, Zwarenstein M. Changes in prescribing patterns following publication of the ALLHAT trial. Journal of the American Medical Association 2004; Vol. 291, issue 1:44‐5. - PubMed
Austin 2005 {published data only}
    1. Austin PC, Mamdani MM. Impact of the pravastatin or avorstatin evaluation and infection therapy‐thrombolysis in myocardial infarction. Circulation 2005;112(9):1296‐300. - PubMed
Avorn 1983 {published data only}
    1. Avorn J, Soumerai SB. Improving drug‐therapy decisions through educational outreach. A randomized controlled trial of academically based "detailing". New England Journal of Medicine 1983;308(24):1457‐63. - PubMed
    1. Soumerai SB, Avorn J. Economic and policy analysis of university‐based drug "detailing". Medical Care 1986; Vol. 24, issue 4:313‐31. - PubMed
    1. Soumerai SB, Avorn J. Predictors of physician prescribing change in an educational experiment to improve medication use. Medical Care 1987; Vol. 25, issue 3:210‐21. - PubMed
Azocar 2003 {published data only}
    1. Azocar F, Cuffel B, Goldman W, McCarter L. The impact of evidence‐based guideline dissemination for the assessment and treatment of major depression in a managed behavioral health care organization. Journal of Behavioral Health Services and Research 2003;30(1):109‐18. - PubMed
    1. Azocar F, Cuffel BD, Goldman W, McCulloch J. Best practices: dissemination of guidelines for the treatment of major depression in a managed behavioral health care network. Psychiatric Services 2001; Vol. 52, issue 8:1014‐6. - PubMed
Barbaglia 2009 {published data only}
    1. Barbaglia G, Macia F, Comas M, Sala M, del MV, Casamitjana M, et al. Trends in hormone therapy use before and after publication of the Women's Health Initiative trial: 10 years of follow‐up. Menopause 2009; Vol. 16, issue 5:1061‐4. - PubMed
Bearcroft 1994 {published data only}
    1. Bearcroft PWP, Small JH, Flower CDR. Chest radiography guidelines for general practitioners: a practical approach. Clinical Radiology 1994;49(1):56‐8. - PubMed
Beaulieu 2004 {published data only}
    1. Beaulieu M‐D, Brophy J, Jacques A, Blais R, Battista R, Lebeau R. Drug treatment of stable angina pectoris and mass dissemination of therapeutic guidelines: a randomized controlled trial. QJM: monthly journal of the Association of Physicians 2004;97(1):21‐31. - PubMed
Bjornson 1990 {published data only}
    1. Bjornson DC, Rector TS, Daniels CE, Wertheimer AI, Snowdon DA, Litman TJ. Impact of a drug‐use review program intervention on prescribing after publication of a randomized clinical trial. American Journal of Hospital Pharmacy 1990;47(7):1541‐6. - PubMed
Black 2002 {published data only}
    1. Black N, Hutchings A. Reduction in the use of surgery for glue ear: did national guidelines have an impact?. Quality and Safety in Health Care 2002;11(2):121‐4. - PMC - PubMed
Buyle 2010 {published data only}
    1. Buyle F, Vogelaers D, Peleman R, Maele G, Robays H. Implementation of guidelines for sequential therapy with fluoroquinolones in a Belgian hospital. Pharmacy World & Science 2010; Vol. 32, issue 3:404‐10. - PubMed
Coopersmith 2002 {published data only}
    1. Coopersmith CM, Rebmann TL, Zack JE, Ward MR, Corcoran RM, Schallom ME, et al. Effect of an education program on decreasing catheter‐related bloodstream infections in the surgical intensive care unit. Critical Care Medicine 2002; Vol. 30, issue 1:59‐64. - PubMed
Denig 1990 {published data only}
    1. Denig P, Haaijer‐Ruskamp FM, Zijsling DH. Impact of a drug bulletin on the knowledge, perception of drug utility, and prescribing behavior of physicians. DICP: the annals of pharmacotherapy 1990;24(1):87‐93. - PubMed
Dormuth 2004 {published data only}
    1. Dormuth CR, Maclure M, Bassett K, Jauca C, Whiteside C, Wright JM. Effect of periodic letters on evidence‐based drug therapy on prescribing behaviour: a randomized trial. CMAJ: Canadian Medical Association Journal 2004;171(9):1057‐61. - PMC - PubMed
Fijn 2000 {published data only}
    1. Fijn R, Stuurman‐Bieze AGG, Berg PB, Brouwers JRBJ, Graeff PA, Jong‐van Den B. Predictors for prophylactic antithrombotic prescribing in ischaemic heart disease and the impact of national guidelines. European Journal of Clinical Pharmacology 2000; Vol. 56, issue 9‐10:739‐46. - PubMed
Fonarow 2009 {published data only}
    1. Fonarow GC, French WJ, Frederick PD. Trends in the use of lipid‐lowering medications at discharge in patients with acute myocardial infarction: 1998 to 2006. American Heart Journal 2009; Vol. 157, issue 1:185‐94. - PubMed
Fukuda 2009 {published data only}
    1. Fukuda H, Imanaka Y, Ishizaki T, Okuma K, Shirai T. Change in clinical practice after publication of guidelines on breast cancer treatment. International Journal for Quality in Health Care 2009; Vol. 21, issue 5:372‐8. - PubMed
Guay 2007 {published data only}
    1. Guay MP, Dragomir A, Pilon D, Moride Y, Perreault S. Changes in pattern of use, clinical characteristics and persistence rate of hormone replacement therapy among postmenopausal women after the WHI publication. Pharmacoepidemiology and Drug Safety 2007; Vol. 16, issue 1:17‐27. - PubMed
Haas 2004 {published data only}
    1. Haas JS, Kaplan CP, Gerstenberger EP, Kerlikowske K. Changes in the use of postmenopausal hormone therapy after the publication of clinical trial results. Annals of Internal Medicine 2004; Vol. 140, issue 3:184‐8. - PubMed
Hersh 2004 {published data only}
    1. Hersh AL, Stefanick ML, Stafford RS. National use of postmenopausal hormone therapy: annual trends and response to recent evidence. Journal of the American Medical Association 2004; Vol. 291, issue 1:47‐53. - PubMed
Jackevicius 2001 {published data only}
    1. Jackevicius CA, Anderson GM, Leiter L, Tu JV. Use of the statins in patients after acute myocardial infarction: does evidence change practice?. Archives of Internal Medicine 2001; Vol. 161, issue 2:183‐8. - PubMed
Jameson 2010 {published data only}
    1. Jameson SS, Bottle A, Malviya A, Muller SD, Reed MR. The impact of national guidelines for the prophylaxis of venous thromboembolism on the complications of arthroplasty of the lower limb. Journal of Bone and Joint Surgery ‐ Series B 2010; Vol. 92, issue 1:123‐9. - PubMed
Jousimaa 2002 {published data only}
    1. Jousimaa J, Makela M, Kunnamo I, MacLennan G, Grimshaw JM. Primary care guidelines on consultation practices: the effectiveness of computerized versus paper‐based versions. A cluster randomized controlled trial among newly qualified primary care physicians. International Journal of Technology Assessment Health Care 2002; Vol. 18, issue 3:586‐96. - PubMed
Juurlink 2004 {published data only}
    1. Juurlink DN, Mamdani MM, Lee DS, Kopp A, Austin PC, Laupacis A, et al. Rates of hyperkalemia after publication of the Randomized Aldactone Evaluation Study. New England Journal of Medicine 2004; Vol. 354, issue 6:543‐51. - PubMed
Kabir 2007 {published data only}
    1. Kabir Z, Feely J, Bennett K. Primary care prescribing patterns in Ireland after the publication of large hypertension trials. British Journal of Clinical Pharmacology 2007; Vol. 64, issue 3:381‐5. - PMC - PubMed
Kajita 2010 {published data only}
    1. Kajita E, Nakatani Y, Tamaki J, Ito N, Iki M. Evidence‐based assessment of the effectiveness of a clinical practice guideline for prevention of osteoporosis and osteoporotic fracture. IOF World Congress on Osteoporosis and 10th European Congress on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, IOF WCO ‐ ECCEO 10; 2010 May 5‐8; Florence, Italy. 2010.
    1. Nakatani Y, Tamaki J, Komatsu M, Iki M, Kajita E. Effect of distributing an evidence‐based guideline for prevention of osteoporosis on health education programs in municipal health centers: a randomized controlled trial. Journal of Epidemiology 2012; Vol. 22, issue 2:103‐12. - PMC - PubMed
Kottke 1989 {published data only}
    1. Kottke TE, Brekke ML, Solberg LI, Hughes JR. Use smoking intervention by physicians. Doctors Helping Smokers, Round I. Journal of the American Medical Association 1989;261(14):2101‐6. - PubMed
Lam 2009 {published data only}
    1. Lam NN, Jain AK, Hackam DG, Cuerden MS, Suri RS, Huo CY, et al. Results of a randomized controlled trial on statin use in dialysis patients had no influence on statin prescription. Kidney International 2009; Vol. 76, issue 11:1172‐9. - PubMed
Majumdar 2003 {published data only}
    1. Majumdar SR, McAlister FA, Soumerai SB. Synergy between publication and promotion: comparing adoption of new evidence in Canada and the United States. American Journal of Medicine 2003;115(6):467‐72. - PubMed
Majumdar 2004 {published data only}
    1. Majumdar SR, Almasi EA, Stafford RS. Promotion and prescribing of hormone therapy after report of harm by the Women's Health Initiative. Journal of the American Medical Association 2004;292(16):1983‐8. - PubMed
Mason 1998/99 {published data only}
    1. Mason J, Freemantle N, Young P. The effect of the distribution of Effective Health Care Bulletins on prescribing selective serotonin reuptake inhibitors in primary care. Health Trends 1998/99;30:120‐2.
Mason 2001 {published data only}
    1. Mason J, Freemantle N, Browning G. Impact of effective health care bulletin on treatment of persistent glue ear in children: time series analysis. BMJ 2001;323(7321):1096‐7. - PMC - PubMed
Matowe 2002 {published data only}
    1. Matowe L, Ramsay CR, Grimshaw JM, Gilbert FJ, Macleod MJ, Needham G. Effects of mailed dissemination of the Royal College of Radiologists' guidelines on general practitioner referrals for radiography: a time series analysis. Clinical Radiology 2002;57(7):575‐8. - PubMed
Meyer 2007 {published data only}
    1. Meyer E, Buttler J, Schneider C, Strehl E, Schroeren‐Boersch B, Gastmeier P, et al. Modified guidelines impact on antibiotic use and costs: Dduration of treatment for pneumonia in a neurosurgical ICU is reduced. Journal of Antimicrobial Chemotherapy 2007; Vol. 59, issue 6:1148‐54. - PubMed
Oakeshott 1994 {published data only}
    1. Oakeshott P, Kerry SM, Williams JE. Randomized controlled trial of the effect of the Royal College of Radiologists' guidelines on general practitioners' referrals for radiographic examination. British Journal of General Practice 1994;44(382):197‐200. - PMC - PubMed
Perria 2007 {published data only}
    1. Perria C, Group IS. Strategies for the introduction and implementation of a guideline for the treatment of type 2 diabetics by general practitioners (GPs) of the Lazio region of Italy (IMPLEMEG study): protocol for a cluster randomised controlled trial. BMC Health Services Research 2004; Vol. 4, issue 1:13. - PMC - PubMed
    1. Perria C, Mandolini D, Guerrera C, Jefferson T, Billi P, Calzini V, et al. Implementing a guideline for the treatment of type 2 diabetics: results of a cluster ‐ randomized controlled trial (C‐RCT). BMC Health Services Research 2007; Vol. 7, issue 79. - PMC - PubMed
Roberts 2007 {published data only}
    1. Roberts VI, Esler CN, Harper WM. What impact have NICE guidelines had on the trends of hip arthroplasty since their publication? The results from the Trent Regional Arthroplasty Study between 1990 and 2005. Journal of Bone and Joint Surgery ‐ Series B 2007; Vol. 89, issue 7:864‐7. - PubMed
Santerre 1996 {published data only}
    1. Santerre RE. The effect of the ACOG guideline on vaginal births after cesarean. Medical Care Research and Review 1996;53(3):315‐29. - PubMed
Shah 2008 {published data only}
    1. Shah BR, Juurlink DN, Austin PC, Mamdani MM. New use of rosiglitazone decreased following publication of a meta‐analysis suggesting harm. Diabetic Medicine 2008; Vol. 25, issue 7:871‐4. - PubMed
Stafford 2004 {published data only}
    1. Stafford RS, Furberg CD, Finkelstein SN, Cockburn IM, Alehegn T, Ma J. Impact of clinical trial results on national trends in alpha‐blocker prescribing, 1996‐2002. Journal of the American Medical Association 2004; Vol. 291, issue 1:54‐62. - PubMed
Tsuji 2009 {published data only}
    1. Tsuji SR, Atallah AN, Aranha FC, Tonhom AP, Siqueira AC, Jr, et al. Cluster randomized clinical trial (ISRCTN23732000) to evaluate the effectiveness of a diagnosis recognition and treatment guide for depressive disorders in primary care [MEDLINE]. Journal of Evaluation in Clinical Practice 2009; Vol. 15, issue 1:222‐5. - PubMed
Wang 2005 {published data only}
    1. Wang YR, Alexander GC, Meltzer DO. Lack of effect of guideline changes on LDL cholesterol reporting and control for diabetes visits in the U.S., 1995‐2004. Diabetes Care 2005; Vol. 28, issue 12:2942‐4. - PubMed
Watson 2001 {published data only}
    1. Watson M, Gunnell D, Peters T, Brookes S, Sharp D. Guidelines and educational outreach visits from community pharmacists to improve prescribing in general practice: a randomised controlled trial. Journal of Health Services Research & Policy 2001; Vol. 6, issue 4:207‐13. - PubMed
Weiss 2011 {published data only}
    1. Weiss K, Blais R, Fortin A, Lantin S, Gaudet M. Impact of a multipronged education strategy on antibiotic prescribing in Quebec, Canada. Clinical Infectious Diseases 2011; Vol. 53, issue 5:433‐9. - PubMed

References to studies excluded from this review

Bishop 2010 {published data only}
    1. Bishop PB, Quon JA, Fisher CG, Dvorak MF. The Chiropractic Hospital‐based Interventions Research Outcomes (CHIRO) study: a randomized controlled trial on the effectiveness of clinical practice guidelines in the medical and chiropractic management of patients with acute mechanical low back pain. The Spine Journal 2010; Vol. 10, issue 12:1055‐64. - PubMed
Croudace 2003 {published data only}
    1. Croudace T, Evans J, Harrison G, Sharp DJ, Wilkinson E, McCann G, et al. Impact of the ICD‐10 primary health care (PHC) diagnostic and management guidelines for mental disorders on detection and outcome in primary care. British Journal of Psychiatry 2003;182:20‐30. - PubMed
Emslie 1993 {published data only}
    1. Emslie C, Grimshaw J, Templeton A. Do clinical guidelines improve general practice management and referral of infertile couples?. BMJ 1993; Vol. 306, issue 6894:1728‐31. - PMC - PubMed
Engers 2005 {published data only}
    1. Engers AJ, Wensing M, Tulder MW, Timmermans A, Oostendorp RA, Koes BW, et al. Implementation of the Dutch low back pain guideline for general practitioners: a cluster randomized controlled trial. Spine 2005;30(6):559‐600. - PubMed
Evans 2010 {published data only}
    1. Evans DW, Breen AC, Pincus T, Sim J, Underwood M, Vogel S, et al. The effectiveness of a posted information package on the beliefs and behavior of musculoskeletal practitioners: the UK Chiropractors, Osteopaths, and Musculoskeletal Physiotherapists Low Back Pain ManagemENT (COMPLeMENT) randomized trial. Spine 2010; Vol. 35, issue 8:858‐66. - PubMed
Ferrari 2005 {published data only}
    1. Ferrari R, Rowe BH, Majumdar SR, Cassidy JD, Blitz S, Wright SC, et al. Simple educational intervention to improve the recovery from acute whiplash: results of a randomized, controlled trial. Academic Emergency Medicine 2005;12(8):699‐706. - PubMed
Fontaine 2006 {published data only}
    1. Fontaine A, Mahe I, Bergmann JF, Fiessinger JN, Dhote R, Cohen P, et al. Effectiveness of written guidelines on the appropriateness of thromboprophylaxis prescriptions for medical patients: a prospective randomized study. Journal of Internal Medicine 2006; Vol. 260, issue 4:369‐76. - PubMed
Hazard 1997 {published data only}
    1. Hazard RG, Haugh LD, Reid S, McFarlane G, MacDonald L. Early physician notification of patient disability risk and clinical guidelines after low back injury: a randomized controlled trial. Spine 1997;22(24):2951‐8. - PubMed
Hunskaar 1996 {published data only}
    1. Hunskaar S, Hannestad YS, Backe B, Matheson I. Direct mailing of consensus recommendations did not alter GPs' knowledge and prescription of oestrogen in the menopause. Scandinavian Journal of Primary Health Care 1996; Vol. 14, issue 4:203‐8. - PubMed
Jackevicius 1999 {published data only}
    1. Jackevicius CA, Chapman KR. Inhaler education for hospital‐based pharmacists: how much is required?. Canadian Respiratory Journal 1999; Vol. 6, issue 3:237‐44. - PubMed
Jain 2006 {published data only}
    1. Jain MK, Heyland D, Dhaliwal R, Day AG, Drover J, Keefe L, et al. Dissemination of the Canadian clinical practice guidelines for nutrition support: results of a cluster randomized controlled trial. Critical Care Medicine 2006; Vol. 34, issue 9:2362‐9. - PubMed
Janmeja 2009 {published data only}
    1. Janmeja AK, Mohapatra PR, Kumar M. The impact of "World Health Organization ‐ Government of India guidelines on chronic obstructive pulmonary diseases‐2003" on quality of life. Lung India 2009; Vol. 26, issue 4:102‐5. - PMC - PubMed
Kocher 2003 {published data only}
    1. Kocher MS, Mandiga R, Murphy JM, Goldmann D, Harper M, Sundel R, et al. A clinical practice guideline for treatment of septic arthritis in children: efficacy in improving process of care and effect on outcome of septic arthritis of the hip. Journal of Bone & Joint Surgery, American Volume 2003; Vol. 85A, issue 6:994‐9. - PubMed
Kulkarni 1998 {published data only}
    1. Kulkarni K, Castle G, Gregory R, Holmes A, Leontos C, Powers M, et al. Nutrition practice guidelines for type 1 diabetes mellitus positively affect dietician practices and patient outcomes. The Diabetes Care and Education Dietetic Practice Group. Journal of the American Dietetic Association 1998;98(1):62‐70. - PubMed
Maiman 1988 {published data only}
    1. Maiman LA, Becker MH, Liptak GS, Nazarian LF, Rounds KA. Improving pediatricians' compliance‐enhancing practices. A randomized trial. American Journal of Diseases of Children 1988; Vol. 142, issue 7:773‐9. - PubMed
Majumdar 2008 {published data only}
    1. Majumdar SR, Johnson JA, McAlister FA, Bellerose D, Russell AS, Hanley DA, et al. Multifaceted intervention to improve diagnosis and treatment of osteoporosis in patients with recent wrist fracture: a randomized controlled trial. CMAJ: Canadian Medical Association Journal 2008; Vol. 178, issue 5:569‐75. - PMC - PubMed
Martino 2011 {published data only}
    1. Martino P, Ban KM, Bartoloni A, Fowler KE, Saint S, Mannelli F. Assessing the sustainability of hand hygiene adherence prior to patient contact in the emergency department: a 1‐year postintervention evaluation. AJIC ‐ American Journal of Infection Control 2011; Vol. 39, issue 1:14‐8. - PubMed
Mettes 2010 {published data only}
    1. Mettes TG, Sanden WJ, Bronkhorst E, Grol RP, Wensing M, Plasschaert AJ. Impact of guideline implementation on patient care: a cluster RCT. Journal of Dental Research 2010; Vol. 89, issue 1:71‐6. - PubMed
Mockiene 2011 {published data only}
    1. Mockiene V, Suominen T, Valimaki M, Razbadauskas A, Martinkenas A, Caplinskas S. The impact of an education intervention to change nurses' HIV‐related knowledge and attitudes in Lithuania: a randomized controlled trial. The Journal of the Association of Nurses in AIDS Care : JANAC. 2011; Vol. 22, issue 2:140‐9. - PubMed
Mollon 2009 {published data only}
    1. Mollon DL, Fields WL. Is this the right patient? An educational initiative to improve compliance with two patient identifiers. Journal of Continuing Education in Nursing 2009; Vol. 40, issue 5:221‐7. - PubMed
Morse 2009 {published data only}
    1. Morse L, McDonald M. Failure of a poster‐based educational programme to improve compliance with peripheral venous catheter care in a tertiary hospital. A clinical audit. Journal of Hospital Infections 2009; Vol. 72, issue 3:221‐6. - PubMed
Ozgun 2010 {published data only}
    1. Ozgun H, Ertugrul BM, Soyder A, Ozturk B, Aydemir M. Peri‐operative antibiotic prophylaxis: adherence to guidelines and effects of educational intervention. International Journal of Surgery 2010; Vol. 8, issue 2:159‐63. - PubMed
Perez‐Jauregui 2008 {published data only}
    1. Perez‐Jauregui J, Gonzalez‐Cardel AM, Olay‐Fuentes G, Reza‐Albarran A, Mehta R, Aguilar‐Salinas CA. Inclusion of educational messages in laboratory reports aids to complete the diagnostic workup of hyperglycemia. Diabetes Care. 2008/02/13 2008; Vol. 31, issue 5:882‐3. - PubMed
Richardson 2002 {published data only}
    1. Richardson B, Kitchen G, Livingston G. The effect of education on knowledge and management of elder abuse: a randomized controlled trial. Age Ageing 2002; Vol. 31, issue 5:335‐41. - PubMed
Schwartz 2007 {published data only}
    1. Schwartz DN, Abiad H, DeMarais PL, Armeanu E, Trick WE, Wang Y, et al. An educational intervention to improve antimicrobial use in a hospital‐based long‐term care facility. Journal of the American Geriatrics Society 2007; Vol. 55, issue 8:1236‐42. - PubMed
Simon 2007 {published data only}
    1. Simon SR, Rodriguez HP, Majumdar SR, Kleinman K, Warner C, Salem‐Schatz S, et al. Economic analysis of a randomized trial of academic detailing interventions to improve use of antihypertensive medications. Journal of Clinical Hypertension (Greenwich, Conn.) 2007; Vol. 9, issue 1:15‐20. - PMC - PubMed
Steffensen 1997 {published data only}
    1. Steffensen FH, Sorensen HT, Olesen F. Impact of local evidence‐based clinical guidelines ‐ a Danish intervention study. Family Practice 1997;14(3):209‐15. - PubMed

References to ongoing studies

Shah 2010 {published data only}
    1. Shah BR, Bhattacharyya O, Yu C, Mamdani M, Parsons JA, Straus SE, et al. Evaluation of a toolkit to improve cardiovascular disease screening and treatment for people with type 2 diabetes: protocol for a cluster‐randomized pragmatic trial. Trials. 2010/04/27 2010; Vol. 11:44. - PMC - PubMed
Zwarenstein 2007 {published data only}
    1. Zwarenstein M, Hux JE, Kelsall D, Paterson M, Grimshaw J, Davis D, et al. The Ontario printed educational message (OPEM) trial to narrow the evidence‐practice gap with respect to prescribing practices of general and family physicians: a cluster randomized controlled trial, targeting the care of individuals with diabetes and hypertension in Ontario, Canada. Implementation Science 2007; Vol. 2:37. - PMC - PubMed

Additional references

Ancker 2007
    1. Ancker JS, Kaufman D. Rethinking health numeracy: a multidisciplinary literature review. Journal of the American Medical Informatics Association 2007; Vol. 14, issue 6:713‐21. - PMC - PubMed
Arnold 2005
    1. Arnold SR, Straus SE. Interventions to improve antibiotic prescribing practices in ambulatory care. Cochrane Database of Systematic Reviews 2005, issue 4:CD003539. - PMC - PubMed
Baker 2010
    1. Baker R, Camosso‐Stefinovic J, Gillies C, Shaw EJ, Cheater F, Flottorp S, et al. Tailored interventions to overcome identified barriers to change: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 2010, issue 3. - PMC - PubMed
Bero 1998
    1. Bero L, Grilli R, Grimshaw J, Harvey E, Oxman A, Thomson MA. Closing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings. BMJ 1998;317(7156):465‐8. - PMC - PubMed
Bull 2001
    1. Bull F, Kreuter M, Clark E, Scharff D. Understanding the effects of printed health education material which features lead to which outcomes. Journal of Health Communication 2001;6(3):265‐79. - PubMed
Burgers 2003a
    1. Burgers J, Grol R, Zaat J, Spies T, Bij A, Mokkink H. Characteristics of effective guidelines for general practice. British Journal of General Practice 2003;53(486):15‐9. - PMC - PubMed
Chastre 2003
    1. Chastre J. Antimicrobial treatment of hospital‐acquired pneumonia. Infectious disease clinics of North America 2003;17(4):727‐37. [PUBMED: 15008595] - PubMed
Chatfield 2001
    1. Chatfield C. Time‐series forecasting. Florida: Chapman & Hall/CRC Press, 2001.
Davis 2009
    1. Davis D, Galbraith R. Continuing medical education effect on practice performance: effectiveness of continuing medical education: American College of Chest Physicians Evidence‐Based Educational Guidelines. Chest. 2009/03/20 2009; Vol. 135, issue 3 Suppl:42S‐8S. - PubMed
de Belvis 2009
    1. Belvis AG, Pelone F, Biasco A, Ricciardi W, Volpe M. Can primary care professionals' adherence to Evidence Based Medicine tools improve quality of care in type 2 diabetes mellitus? A systematic review. Diabetes Research and Clinical Practice 2009; Vol. 85, issue 2:119‐31. - PubMed
Donner 2001
    1. Donner A, Piaggio G, Villar J. Statistical methods for the meta‐analysis of cluster randomization trials. Statistical Methods in Medical Research 2001; Vol. 10, issue 5:325‐38. - PubMed
Flodgren 2011
    1. Flodgren G, Parmelli E, Doumit G, Gattellari M, O'Brien MA, Grimshaw J, et al. Local opinion leaders: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 2011, issue 8:CD000125. - PMC - PubMed
Forsetlund 2009
    1. Forsetlund L, Bjorndal A, Rashidian A, Jamtvedt G, O'Brien MA, Wolf F, et al. Continuing education meetings and workshops: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 2009, issue 2:CD003030. - PMC - PubMed
Foy 2002
    1. Foy R, McLennan G, Grimshaw J, Penney G, Campbell M, Grol R. Attributes of clinical recommendations that influence change in practice following audit and feedback. Journal of Clinical Epidemiology 2002;55:717‐22. - PubMed
Freemantle 1997
    1. Freemantle N, Harvey EL, Wolf F, Grimshaw JM, Grilli R, Bero LA. Printed educational materials: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 1997, Issue 2. [DOI: 10.1002/14651858.CD000172] - DOI - PubMed
French 2010
    1. French SD, Green S, Buchbinder R, Barnes H. Interventions for improving the appropriate use of imaging in people with musculoskeletal conditions. Cochrane Database of Systematic Reviews 2010, issue 1:CD006094. - PMC - PubMed
Graham 2006
    1. Graham I, Logan J, Harrison M, Straus S, Tetroe J, Caswell W, et al. Lost in knowledge translation: time for a map?. Journal of Continuing Education in the Health Professions 2006; Vol. 26, issue 1:13‐24. - PubMed
Grandage 2002
    1. Grandage KK, Slawson DC, Shaughnessy AF. When less is more: a practical approach to searching for evidence‐based answers. Journal of the Medical Library Association 2002; Vol. 90, issue 3:298‐304. - PMC - PubMed
Grilli 2002
    1. Grilli R, Ramsay C, Minozzi S. Mass media interventions: effects on health services utilisation. Cochrane Database of Systematic Reviews 2002, issue 1:CD000389. [1469‐493X: (Electronic); MEDLINE: ] - PubMed
Grimshaw 2003
    1. Grimshaw J, McAuley LM, Bero LA, Grilli R, Oxman AD, Ramsay C, et al. Systematic reviews of the effectiveness of quality improvement strategies and programmes. Quality and Safety in Health Care 2003; Vol. 12, issue 4:298‐303. [1475‐3898: (Print); MEDLINE: ] - PMC - PubMed
Grimshaw 2004
    1. Grimshaw JM, Thomas RE, MacLennan G, Fraser C, Ramsay CR, Vale L, et al. Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technology Assessment 2004;8(6):iii‐iv, 1‐72. - PubMed
Grimshaw 2006
    1. Grimshaw J, Eccles M, Thomas R, MacLennan G, Ramsay C, Fraser C, et al. Toward evidence‐based quality improvement. Evidence (and its limitations) of the effectiveness of guideline dissemination and implementation strategies 1966‐1998. Journal of General Internal Medicine 2006; Vol. 21 Suppl 2:S14‐20. - PMC - PubMed
Grol 1998
    1. Grol R, Dalhuijsen J, Thomas S, Veld C, Rutten G, Mokkink H. Attributes of clinical guidelines that influence of guidelines in general practice: observational study. BMJ 1998;317:858‐61. - PMC - PubMed
Grol 2001
    1. Grol R. Successes and failures in the implementation of evidence‐based guidelines for clinical practice. Medical Care 2001; Vol. 39, issue 8 Suppl 2:II46‐54. - PubMed
Grol 2003
    1. Grol R, Grimshaw J. From best evidence to best practice: effective implementation of change in patients' care. Lancet. 2003/10/22 2003; Vol. 362, issue 9391:1225‐30. - PubMed
Grol 2007
    1. Grol RP, Bosch MC, Hulscher ME, Eccles MP, Wensing M. Planning and studying improvement in patient care: the use of theoretical perspectives. Milbank Quarterly 2007; Vol. 85, issue 1:93‐138. - PMC - PubMed
Gross 2001
    1. Gross PA, Greenfield S, Cretin S, Ferguson J, Grimshaw J, Grol R, et al. Optimal methods for guideline implementation: conclusions from Leeds Castle meeting. Medical Care 2001; Vol. 39, issue 8 Suppl 2:II85‐92. - PubMed
Hakkennes 2008
    1. Hakkennes S, Dodd K. Guideline implementation in allied health professions: a systematic review of the literature. Quality and Safety in Health Care 2008; Vol. 17, issue 4:296‐300. - PubMed
Haynes 2007
    1. Haynes B. Of studies, syntheses, synopses, summaries, and systems: the "5S" evolution of information services for evidence‐based healthcare decisions. Evidence‐Based Nursing. 2007/01/16 2007; Vol. 10, issue 1:6‐7. - PubMed
Higgins 2011
    1. Higgins J, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 [updated March 2011]. The Cochrane Collaboration, 2011. http://www.cochrane‐handbook.org/.
Hoffman 2004
    1. Hoffman T, Worrall L. Designing effective written health education materials: considerations for health professionals. Disability and Rehabilitation 2004;26(19):1163‐73. - PubMed
Jamtvedt 2006
    1. Jamtvedt G, Young JM, Kristoffersen DT, O'Brien MA, Oxman AD. Audit and feedback: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews. 2006/04/21 2006, issue 2:CD000259. - PubMed
Kanouse 1995
    1. Kanouse D, Kallich J, Kahan J. Dissemination of effectiveness and outcomes research. Health Policy 1995;34(3):167‐92. - PubMed
Kreuter 1996
    1. Kreuter MW, Strecher VJ. Do tailored behaviour change messages enhance the effectiveness of health risk appraisals? results from a randomized controlled trial. Health Education Research 1996;11(1):97‐105. - PubMed
Lagarde 2012
    1. Lagarde M. How to do (or not to do) ... Assessing the impact of a policy change with routine longitudinal data. Health Policy Plan. 2011/02/01 2012; Vol. 27, issue 1:76‐83. - PubMed
Marriott 2000
    1. Marriott S, Palmer C, Lelliott P. Disseminating healthcare information: getting the message across. Quality in Health Care 2000;9(1):58‐62. - PMC - PubMed
McGuire 1989
    1. McGuire WJ. Theoretical foundations of campaigns. In: Rice R, Atkins C editor(s). Public Communication Campaigns. California: Sage Publication, Inc., 1989.
NHS 1999
    1. NHS CforRandD. Getting evidence into practice. Effective Health Care 1999; Vol. 5:1–16.
O'Brien 2007
    1. O'Brien MA, Rogers S, Jamtvedt G, Oxman AD, Odgaard‐Jensen J, Kristoffersen DT, et al. Educational outreach visits: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews. 2007/10/19 2007, issue 4:CD000409. - PMC - PubMed
Ramsay 2003
    1. Ramsay CR, Matowe L, Grilli R, Grimshaw JM, Thomas RE. Interrupted time series designs in health technology assessment: lessons from two systematic reviews of behavior change strategies. International Journal of Technology Assessment in Health Care 2003;19(4):613‐23. - PubMed
Revere 2001
    1. Revere D, Dunbar P. Review of computer‐generated outpatient health behavior interventions: clinical encounters in absentia. Journal of the American Medical Informatics Association 2001;8(1):62‐79. - PMC - PubMed
RevMan 2011 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.
Rogers 1995
    1. Rogers EM. Diffusion of innovations. New York: Free Press, 1995.
Rosenbaum 2010
    1. Rosenbaum ME. Improving the User Experience of Evidence: a Design Approach to Evidence‐informed Healthcare [PhD thesis]. Oslo: The Oslo School of Architecture and Design, 2010:170.
Schuster 2005
    1. Schuster MA, McGlynn EA, Brook RH. How good is the quality of health care in the United States? 1998. Milbank Quarterly. 2005/11/11 2005; Vol. 83, issue 4:843‐95. - PMC - PubMed
Seitz 2011
    1. Seitz P, Rosemann T, Gensichen J, Huber CA. Interventions in primary care to improve cardiovascular risk factors and glycated haemoglobin (HbA1c) levels in patients with diabetes: a systematic review. Diabetes Obesity and Metabolism. 2011/01/06 2011; Vol. 13, issue 6:479‐89. - PubMed
Shojania 2010
    1. Shojania KG, Jennings A, Mayhew A, Ramsay C, Eccles M, Grimshaw J. Effect of point‐of‐care computer reminders on physician behaviour: a systematic review. CMAJ: Canadian Medical Association Journal. 2010/03/10 2010; Vol. 182, issue 5:E216‐25. - PMC - PubMed
Stergiou‐Kita 2010
    1. Stergiou‐Kita M. Implementing clinical practice guidelines in occupational therapy practice: recommendations from the research evidence. Australian Occupational Therapy Journal. 2010/09/22 2010; Vol. 57, issue 2:76‐87. - PubMed
Tseng 1999
    1. Tseng S, Fogg B. Credibility and computing technology. Communications of the ACM 1999;42(5):39‐44.
Wang 2009
    1. Wang R, Bartlett G, Grad R, Pluye P. The cognitive impact of research synopses on physicians: a prospective observational analysis of evidence‐based summaries sent by email. Informatics in Primary Care. 2009/10/08 2009; Vol. 17, issue 2:79‐86. - PubMed
Wathen 2002
    1. Wathen CN, Burkell J. Believe it or not: factors influencing credibility on the web. Journal of the American Society for Information Science and Technology 2002;53(2):134‐44.
Weinmann 2007
    1. Weinmann S, Koesters M, Becker T. Effects of implementation of psychiatric guidelines on provider performance and patient outcome: systematic review. Acta Psychiatrica Scandinavica. 2007/05/15 2007; Vol. 115, issue 6:420‐33. - PubMed
Wilson 2010
    1. Wilson PM, Petticrew M, Calnan MW, Nazareth I. Disseminating research findings: what should researchers do? A systematic scoping review of conceptual frameworks. Implementation Science. 2010/11/26 2010; Vol. 5:91. - PMC - PubMed
Wood 2008
    1. Wood L, Egger M, Gluud LL, Schulz KF, Juni P, Altman DG, et al. Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta‐epidemiological study. BMJ. 2008/03/05 2008; Vol. 336, issue 7644:601‐5. - PMC - PubMed
Woolf 1999
    1. Woolf SH, Grol R, Hutchinson A, Eccles M, Grimshaw J. Clinical guidelines: potential benefits, limitations, and harms of clinical guidelines. BMJ. 1999/02/19 1999; Vol. 318, issue 7182:527‐30. - PMC - PubMed

References to other published versions of this review

Farmer 2008
    1. Farmer AP, Legare F, Turcot L, Grimshaw J, Harvey E, McGowan JL, et al. Printed educational materials: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 2008, issue 3:CD004398. - PubMed

Publication types

MeSH terms