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Changing physician behavior: what works?
Fargoi Mostofian, Cynthiya Ruban, Nicole Simunovic
1293 Wellington St N, Ste 110, Hamilton, ON, L8L 8E7.
The American Journal of Managed Care
|April 17, 2015
Summary
Active educational methods and multifaceted interventions are most effective for implementing clinical guidelines in general practice. These active approaches significantly improve physician practice patterns compared to passive methods.
Area of Science:
- Clinical Practice Guidelines
- Healthcare Implementation Science
- Physician Behavior Change
Background:
- Effectiveness of interventions for guideline implementation in clinical practice remains unclear.
- Need to identify optimal strategies for translating research findings into physician practice.
Purpose of the Study:
- To systematically review and identify effective methods for implementing clinical guidelines.
- To assess interventions aimed at changing physician practice patterns in surgical and general practice.
Main Methods:
- Systematic review of existing systematic reviews.
- Searched MEDLINE, EMBASE, and PubMed for relevant English-language reviews.
- Independent assessment of eligibility, quality, and data extraction by two reviewers.
Main Results:
- Fourteen reviews identified a range of interventions including audit and feedback, decision support systems, and continuing medical education.
- Active approaches (e.g., academic detailing) showed greater effectiveness than passive methods.
- 71% of studies in 3 reviews demonstrated positive physician behavior change with active educational methods and multifaceted interventions.
Conclusions:
- Active continuing medical education and multifaceted interventions are most effective for guideline implementation in general practice.
- Active physician performance improvement strategies outperform traditional passive methods.
- Further research is needed for surgical settings.
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