Effectiveness of guideline dissemination and implementation strategies on health care professionals’ behaviour and patient outcomes in the cancer care context: a systematic review
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Authors
Tomasone, Jennifer R.
Kauffeldt, Kaitlyn
Chaudhary, Rushil
Brouwers, Melissa C.
Date
2020-06
Type
journal article
Language
en
Keyword
Clinical practice guidelines , Cancer care , dissemination , implementation , Medical health care professionals , Allied health care professionals
Alternative Title
Abstract
Background
Health care professionals (HCPs) use clinical practice guidelines (CPGs) to make evidence-informed decisions regarding patient care. Although a large number of cancer-related CPGs exist, it is unknown which CPG dissemination and implementation strategies are effective for improving HCP behaviour and patient outcomes in a cancer care context. This review aimed to determine the effectiveness of CPG dissemination and/or implementation strategies among HCPs in a cancer care context.
Methods
A comprehensive search of five electronic databases was conducted. Studies were limited to the dissemination and/or implementation of a CPG targeting both medical and/or allied HCPs in cancer care. Two reviewers independently coded strategies using the Mazza taxonomy, extracted study findings, and assessed study quality.
Results
The search strategy identified 33 studies targeting medical and/or allied HCPs. Across the 33 studies, 23 of a possible 49 strategies in the Mazza taxonomy were used, with a mean number of 3.25 (SD = 1.45) strategies per intervention. The number of strategies used per intervention was not associated with positive outcomes. Educational strategies (n = 24), feedback on guideline compliance (n = 11), and providing reminders (n = 10) were the most utilized strategies. When used independently, providing reminders and feedback on CPG compliance corresponded with positive significant changes in outcomes. Further, when used as part of multi-strategy interventions, group education and organizational strategies (e.g. creation of an implementation team) corresponded with positive significant changes in outcomes.
Conclusions
Future CPG dissemination and implementation interventions for cancer care HCPs may benefit from utilizing the identified strategies. Research in this area should aim for better alignment between study objectives, intervention design, and evaluation measures, and should seek to incorporate theory in intervention design, so that behavioural antecedents are considered and measured; doing so would enhance the field’s understanding of the causal mechanisms by which interventions lead, or do not lead, to changes in outcomes at all levels.
Description
Published version available: https://doi.org/10.1186/s13012-020-0971-6
Citation
Tomasone, J. R., Kauffeldt, K. D., Chaudhary, R., & Brouwers, M. C. (2020). Effectiveness of guideline dissemination and implementation strategies on health care professionals' behaviour and patient outcomes in the cancer care context: a systematic review. Implementation science : IS, 15(1), 41. https://doi.org/10.1186/s13012-020-0971-6
Publisher
BMC (Implementation Science)