Implementability of clinical practice guidelines: the review and development of a Comprehensive Framework for...

Area of Science:

• Healthcare Policy
• Clinical Practice Guidelines
• Health Services Research

Background:

• Clinical practice guidelines (CPGs) implementability is crucial for adoption in clinical settings.
• Existing frameworks may not comprehensively address guideline implementability.
• A systematic approach is needed to develop a robust implementability framework.

Purpose of the Study:

• To create a comprehensive and evidence-informed framework of guideline implementability (CFGI).
• To establish a theoretical basis for developing and implementing future CPGs.
• To enhance the promotion and application of guidelines in diverse medical environments.

Main Methods:

• A mixed-methods approach integrating systematic literature review, external consultations, and natural language processing.
• Systematic literature review of six databases to form the initial framework.
• External validation through expert feedback at an international conference.

Main Results:

• The final CFGI comprises 6 core domains and 21 constructs, covering scope, clarity, evidence base, structure, development, and implementation environment.
• Fifteen studies informed the initial framework, with feedback from 16 stakeholders.
• External validation by 29 experts confirmed the CFGI's rationality, importance, clarity, feasibility, and necessity.

Conclusions:

• The developed CFGI offers a systematic theoretical foundation for future CPG development and implementation.
• The CFGI is expected to improve guideline implementability and facilitate their use in clinical practice.
• Further research is recommended to validate and apply the CFGI in real-world settings.