Abstract
Research indicates that clinical guidelines are often not applied. The success of their implementation depends on the consideration of a variety of barriers and the use of adequate strategies to overcome them. Therefore, this scoping review aims to describe and categorize the most important barriers to guideline implementation. Furthermore, it provides an overview of different kinds of suitable strategies that are tailored to overcome these barriers. The search algorithm led to the identification of 1659 articles in PubMed. Overall, 69 articles were included in the data synthesis. The content of these articles was analysed by using a qualitative synthesis approach, to extract the most important information on barriers and strategies. The barriers to guideline implementation can be differentiated into personal factors, guideline-related factors, and external factors. The scoping review revealed the following aspects as central elements of successful strategies for guideline implementation: dissemination, education and training, social interaction, decision support systems and standing orders. Available evidence indicates that a structured implementation can improve adherence to guidelines. Therefore, the barriers to guideline implementation and adherence need to be analysed in advance so that strategies that are tailored to the specific setting and target groups can be developed.
Highlights
IntroductionClinical practice guidelines (hereafter referred to as guidelines) can be defined as “systematically developed statements to assist practitioners’ decisions about appropriate health care for specific clinical circumstances” [1]
Clinical practice guidelines can be defined as “systematically developed statements to assist practitioners’ decisions about appropriate health care for specific clinical circumstances” [1]
This study aims to describe and categorize the most important barriers to guideline implementation identified by a scoping review
Summary
Clinical practice guidelines (hereafter referred to as guidelines) can be defined as “systematically developed statements to assist practitioners’ decisions about appropriate health care for specific clinical circumstances” [1]. The development and implementation of guidelines is intended to organize and provide the best available evidence to support clinical decision making in order to improve quality of care, patient outcomes and cost effectiveness [3,4]. The criteria and prerequisites for developing guidelines are: a highly prevalent disease or frequently used medical procedure, high associated costs and current variations in practice. They are important for diseases leading to premature mortality, avoidable morbidity or negative effects on health-related quality of life. The evidence should indicate that medical care can make a difference to outcomes [5]
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