Implementation of guidelines in clinical practice; barriers and strategies.

Abstract

Published clinical practice guidelines frequently have difficulties for implementation of the recommendations and adherence in daily clinical practice. The present review summarizes the current knowledge on the barriers encountered when implementing clinical practice guideline and the strategies proposed to address these barriers. Studies on strategies for implementation of clinical guidelines are scarce. Evidence indicates that a multidisciplinary policy is necessary in order to address the barriers at various levels. Continuous education and motivation of the stakeholders, together with structural adaptations are key elements in the process. The barriers for implementation of guidelines involve different levels, including the healthcare system, organizational, societal and cultural specificities, and individual attitudes. All of these should be addressed with policy-driven strategies. Such strategies could include optimization of resources allocations, and establishing well coordinated multidisciplinary networks, finally, future studies should also evaluate the effectiveness of the potential strategies.