| Author | Pereira, Viviane Cássia | |
| Author | Silva, Sara N. | |
| Author | Carvalho, Viviane Karoline da Silva | |
| Author | Zanghelini, Fernando | |
| Author | Barreto, Jorge Otávio Maia | |
| Access date | 2023-06-27T21:24:10Z | |
| Available date | 2023-06-27T21:24:10Z | |
| Document date | 2022 | |
| Citation | PEREIRA, Viviane C. et al. Strategies for the implementation of clinical practice guidelines in public health: an overview of systematic reviews. Health Research Policy and Systems, [s.l.], v. 20, n. 13, p. 1-21, jan. 2022. | en_US |
| ISSN | 1478-4505 | en_US |
| URI | https://www.arca.fiocruz.br/handle/icict/59208 | |
| Sponsorship | Ministério da Saúde do Brasil (TED-MS-FIOCRUZ nº 43/2016) | en_US |
| Language | eng | en_US |
| Publisher | Springer Nature | en_US |
| Rights | open access | en_US |
| MeSH | Health Systems | en_US |
| MeSH | Guidelines as Topic | en_US |
| MeSH | Health Strategies | en_US |
| Title | Strategies for the implementation of clinical practice guidelines in public health: an overview of systematic reviews | en_US |
| Type | Article | en_US |
| DOI | 10.1186/s12961-022-00815-4 | |
| Abstract | Background: As a source of readily available evidence, rigorously synthesized and interpreted by expert clinicians
and methodologists, clinical guidelines are part of an evidence-based practice toolkit, which, transformed into practice recommendations, have the potential to improve both the process of care and patient outcomes. In Brazil, the
process of development and updating of the clinical guidelines for the Brazilian Unified Health System (Sistema Único
de Saúde, SUS) is already well systematized by the Ministry of Health. However, the implementation process of those
guidelines has not yet been discussed and well structured. Therefore, the first step of this project and the primary
objective of this study was to summarize the evidence on the effectiveness of strategies used to promote clinical
practice guideline implementation and dissemination.
Methods: This overview used systematic review methodology to locate and evaluate published systematic reviews
regarding strategies for clinical practice guideline implementation and adhered to the PRISMA guidelines for systematic review (PRISMA).
Results: This overview identified 36 systematic reviews regarding 30 strategies targeting healthcare organizations,
healthcare providers and patients to promote guideline implementation. The most reported interventions were
educational materials, educational meetings, reminders, academic detailing and audit and feedback. Care pathways—
single intervention, educational meeting—single intervention, organizational culture, and audit and feedback—both
strategies implemented in combination with others—were strategies categorized as generally effective from the systematic reviews. In the meta-analyses, when used alone, organizational culture, educational intervention and reminders proved to be effective in promoting physicians’ adherence to the guidelines. When used in conjunction with other
strategies, organizational culture also proved to be effective. For patient-related outcomes, education intervention
showed effective results for disease target results at a short and long term.
Conclusion: This overview provides a broad summary of the best evidence on guideline implementation. Even if the
included literature highlights the various limitations related to the lack of standardization, the methodological quality
of the studies, and especially the lack of conclusion about the superiority of one strategy over another, the summary
of the results provided by this study provides information on strategies that have been most widely studied in the
last few years and their effectiveness in the context in which they were applied. Therefore, this panorama can support
strategy decision-making adequate for SUS and other health systems, seeking to positively impact on the appropriate
use of guidelines, healthcare outcomes and the sustainability of the SUS. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil. | en_US |
| Affilliation | Ministério da Saúde. Brasília, DF, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil. | en_US |
| Subject | Guidelines | en_US |
| Subject | Guideline implementation | en_US |
| Subject | Health system | en_US |
| DeCS | Sistemas de Saúde | en_US |
| DeCS | Guias como Assunto | en_US |
| DeCS | Estratégias de Saúde | en_US |
