Effect of Interventions for Implementing Clinical Practice Guidelines [Internet]

Excerpt

The Norwegian Directorate of Health develops clinical practice guidelines, and requested the Norwegian Knowledge Centre for the Health Services to summarise research findings on the effectiveness of guideline implementation interventions. This report is an overview of existing systematic reviews.

Key findings from the identified systematic reviews are that:

1. Implementation interventions such as electronic decision-support, educational meetings, outreach visits, audit and feedback, and tailored interventions are probably effective, but:

2. The size of the effect varies.The effect on clinical practice is most often moderate.

3. The expected effect on health outcomes is modest.

4. For other of the interventions, the size of the effect varied considerably across studies. It is difficult to explain this variation. Consequently, it is uncertain how much these interventions will improve adherence to clinical guidelines.

5. For some measures, such as financial incentives and public release of performance data, evidence is lacking or scarce. We therefore cannot say how effective these types of interventions are.

Keywords: practice guidelines; quality improvement; review.