Related Experiment Video
Updated: Jan 6, 2026
Using Continuous Data Tracking Technology to Study Exercise Adherence in Pulmonary Rehabilitation
Published on: November 8, 2013
Interventions to improve adherence to clinical practice guidelines when treating cardiovascular disease: a systematic
Sarah McErlean1,2, Louise McCollum3, Mark Ledwidge4
1Department of General Practice, UCD School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland. Sarah.mcerlean@ucd.ie.
Insights
Interventions targeting healthcare professionals show mixed results for improving adherence to cardiovascular disease guidelines. Effective implementation strategies are crucial for bridging the gap between guidelines and practice.
Area of Science:
- Cardiology
- Healthcare Quality Improvement
- Evidence-Based Medicine
Background:
- Clinical practice guidelines aim to enhance cardiovascular disease (CVD) care quality and safety.
- Worldwide, consistent adherence to these guidelines presents a significant challenge in clinical practice.
Purpose of the Study:
- To identify and evaluate interventions directed at healthcare professionals to improve adherence to CVD treatment guidelines.
- Focus areas include atrial fibrillation, ischaemic heart disease, heart failure, dyslipidaemia, and hypertension in ambulatory settings.
Main Methods:
- A comprehensive literature search was conducted across multiple databases (MEDLINE, CINAHL, EMBASE, Cochrane, PsycINFO, ERIC, ASSIA, clinicaltrials.gov, EUtrials) from January 2012 to September 2023.
- Included studies were randomized trials (including cluster and cross-over designs).
- Data extraction and quality assessment were performed independently by two investigators.
Main Results:
- Forty-six studies investigating healthcare-targeted interventions for guideline adherence were identified.
- Educational interventions were the most commonly utilized approach.
- Significant heterogeneity in intervention types and outcome reporting precluded meta-analysis, necessitating a narrative synthesis.
Conclusions:
- Diverse interventions targeting healthcare professionals can potentially improve adherence to CVD guidelines, though overall effectiveness is variable.
- Implementation strategies require parity with guideline development to effectively translate best practices into routine clinical application.
Background:
Clinical practice guidelines have the potential to improve healthcare quality and safety in those with cardiovascular disease. However, guideline adherence is a challenge worldwide.
Aims:
We aim to determine the types and effects of interventions that target healthcare professionals to improve adherence to cardiovascular disease treatment guidelines-specifically for atrial fibrillation, ischaemic heart disease, heart failure, dyslipidaemia, and/or hypertension in ambulatory care.
Methods:
The following databases were searched from January 2012 to September 2023: MEDLINE, CINAHL, EMBASE,Cochrane, PsycINFO, ERIC International, Applied Social Sciences Index and Abstracts, clinicatrial.gov, and EUtrials. The search was supplemented by reviewing the reference lists of included studies, cited articles, and systematic reviews published in the field. Randomised trials, including cluster randomised trials and cross-over designs, were included. Two investigators independently extracted data and assessed study quality.
Results:
Forty-six studies examining the impact of healthcare-targeted interventions on improving guideline adherence were identified. Various approaches were employed, with educational interventions being the most frequently used. Given the heterogeneity in types of intervention and outcomes reported in the included trials, a narrative synthesis of the data was difficult, and meta-analysis was not planned.
Conclusions:
This review demonstrates that a diverse range of interventions aimed at healthcare professionals have the potential to improve adherence to CVD guidelines, but their overall effectiveness remains mixed. To narrow the gap between best practice and real-world guideline application, effective implementation strategies must become as important as guideline development itself.
Related Concept Videos
01:27Peripheral Artery Disease III: Interprofessional Care
01:26Atherosclerosis III: Management
01:27Coronary Artery Disease V: Interprofessional Care
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:29Cardiomyopathy V: Interprofessional Care
01:21Rheumatic Heart Disease III: Medical Management