Trends in guideline implementation: an updated scoping review.

Area of Science:

• Health Services Research
• Evidence-Based Practice
• Knowledge Translation

Background:

• Clinical practice guidelines aim to support evidence-informed practice but often lack effective implementation strategies.
• A previous scoping review highlighted that guideline implementation interventions were not consistently selected or tailored.
• This study aimed to update the previous scoping review on guideline implementation interventions.

Purpose of the Study:

• To systematically review and update the evidence on guideline implementation interventions.
• To identify common intervention characteristics and their reported impact.
• To assess the extent to which implementation planning processes are used.

Main Methods:

• Conducted a systematic search of multiple databases (MEDLINE, EMBASE, AMED, CINAHL, Scopus, Cochrane) for studies published from 2014 to January 2021.
• Screened studies in triplicate and extracted data in duplicate, focusing on study and intervention characteristics and reported impact.
• Included 118 studies evaluating guideline implementation interventions across 16 clinical topics.

Main Results:

• 21% of studies used theories/frameworks, 50% identified barriers, and 36% engaged stakeholders in intervention selection/tailoring.
• Common interventions included professional education (44%) and information systems/technology (41%); 75% used multi-faceted interventions.
• 82% of studies achieved impact, with higher impact rates observed in studies that pre-identified barriers (47.5%) or engaged stakeholders (52.4%).

Conclusions:

• More studies are now using planning processes to select and tailor interventions compared to previous reviews.
• While most studies achieved impact, the role of specific planning processes (frameworks, barrier identification, stakeholder engagement) in achieving impact requires further investigation.
• Future systematic reviews should explore the association between implementation planning strategies and intervention impact.