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Trends in guideline implementation: an updated scoping review.

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This review found more studies are tailoring guideline implementation interventions. Most studies achieved impact, but further research is needed to confirm if planning processes consistently improve outcomes.

Keywords:
GuidelinesImplementation interventionsImplementation strategiesQuality improvementScoping review

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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.