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Erschienen in:

04.05.2018

Systematic Review and Meta-analysis of the Effectiveness of Implementation Strategies for Non-communicable Disease Guidelines in Primary Health Care

verfasst von: Eva Kovacs, Dr. med. PhD, Ralf Strobl, Dr. rer. biol. hum., Dipl.-Stat., Amanda Phillips, MSc, Anna-Janina Stephan, MPH, Martin Müller, MPH, Prof. Dr., Jochen Gensichen, Prof. Dr. med. habil., Dipl.-Päd., MPH, Eva Grill, Prof. Dr., MPH

Erschienen in: Journal of General Internal Medicine | Ausgabe 7/2018

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Abstract

Background

As clinical practice guidelines represent the most important evidence-based decision support tool, several strategies have been applied to improve their implementation into the primary health care system. This study aimed to evaluate the effect of intervention methods on the guideline adherence of primary care providers (PCPs).

Methods

The studies selected through a systematic search in Medline and Embase were categorised according to intervention schemes and outcome indicator categories. Harvest plots and forest plots were applied to integrate results.

Results

The 36 studies covered six intervention schemes, with single interventions being the most effective and distribution of materials the least. The harvest plot displayed 27 groups having no effect, 14 a moderate and 21 a strong effect on the outcome indicators in the categories of knowledge transfer, diagnostic behaviour, prescription, counselling and patient-level results. The forest plot revealed a moderate overall effect size of 0.22 [0.15, 0.29] where single interventions were more effective (0.27 [0.17, 0.38]) than multifaceted interventions (0.13 [0.06, 0.19]).

Discussion

Guideline implementation strategies are heterogeneous. Reducing the complexity of strategies and tailoring to the local conditions and PCPs’ needs may improve implementation and clinical practice.

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Titel: Systematic Review and Meta-analysis of the Effectiveness of Implementation Strategies for Non-communicable Disease Guidelines in Primary Health Care
verfasst von: Eva Kovacs, Dr. med. PhD
Ralf Strobl, Dr. rer. biol. hum., Dipl.-Stat.
Amanda Phillips, MSc
Anna-Janina Stephan, MPH
Martin Müller, MPH, Prof. Dr.
Jochen Gensichen, Prof. Dr. med. habil., Dipl.-Päd., MPH
Eva Grill, Prof. Dr., MPH
Publikationsdatum: 04.05.2018
Verlag: Springer US
Erschienen in: Journal of General Internal Medicine / Ausgabe 7/2018
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-018-4435-5

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Systematic Review and Meta-analysis of the Effectiveness of Implementation Strategies for Non-communicable Disease Guidelines in Primary Health Care

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Methods

Results

Discussion

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