Effects of evidence-based clinical practice guidelines on quality of care: a systematic review

@article{Lugtenberg2009EffectsOE,
  title={Effects of evidence-based clinical practice guidelines on quality of care: a systematic review},
  author={Marjolein Lugtenberg and Jako Burgers and Gert P. Westert},
  journal={Quality and Safety in Health Care},
  year={2009},
  volume={18},
  pages={385 - 392}
}
BACKGROUND Evidence-based clinical guidelines aim to improve the quality of care. [] Key Method The electronic databases Medline and Embase (1990-2007) and relevant scientific journals were searched. Studies were only selected if they included a controlled trial, an interrupted time series design or a before and after design. RESULTS A total of 20 studies were included. In 17 of 19 studies that measured the effects on the process or structure of care, significant improvements were reported. Thirteen of…
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References

SHOWING 1-10 OF 66 REFERENCES
The effects of clinical practice guidelines on patient outcomes in primary care: a systematic review.
  • G. Worrall, P. Chaulk, D. Freake
  • Medicine, Psychology
    CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
  • 1997
TLDR
There is very little evidence that the use of CPGs improves patient outcomes in primary medical care, but most studies published to date have used older guidelines and methods, which may have been insensitive to small changes in outcomes.
Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations.
TLDR
It is concluded that explicit guidelines do improve clinical practice, when introduced in the context of rigorous evaluations, however, the size of the improvements in performance varied considerably.
Towards evidence-based clinical practice: an international survey of 18 clinical guideline programs.
OBJECTIVE To describe systematically the structures and working methods of guideline programs. DESIGN Descriptive survey using a questionnaire with 32 items based on a framework derived from the
Effectiveness and efficiency of guideline dissemination and implementation strategies.
TLDR
There is an imperfect evidence base to support decisions about which guideline dissemination and implementation strategies are likely to be efficient under different circumstances and decision makers need to use considerable judgement about how best to use the limited resources they have for clinical governance and related activities to maximise population benefits.
Toward evidence-based quality improvement. Evidence (and its limitations) of the effectiveness of guideline dissemination and implementation strategies 1966-1998.
TLDR
There is an imperfect evidence base to support decisions about which guideline dissemination and implementation strategies are likely to be efficient under different circumstances, and decision makers need to use considerable judgment about how best to use the limited resources they have for quality improvement activities.
Implementing clinical guidelines: current evidence and future implications.
TLDR
The review suggests that interventions that were previously thought to be ineffective (e.g., dissemination of educational materials) may have modest but worthwhile benefits and that multifaceted interventions were found to be no more effective than single interventions.
Feasibility of a national cholesterol guideline in daily practice. A randomized controlled trial in 20 general practices.
TLDR
The quality of selective case finding, especially the targeting of cholesterol testing to those with positive cardiovascular risk profiles, did not improve following intervention, and performance of the procedure necessary to diagnose hypercholesterolaemia even deteriorated.
Evaluating the Message: The Relationship Between Compliance Rate and the Subject of a Practice Guideline
TLDR
The target area of practice and the complexity and trialability of the recommended procedure appear to be useful, if partial, predictors of the level of compliance with a practice guideline.
Characteristics of effective clinical guidelines for general practice.
TLDR
If the recommendations are not compatible with existing norms and values, not easy to follow or require new knowledge and skills, appropriate implementation strategies should be designed to ensure change in daily practice.
Evaluating the quality of medical care.
TLDR
This paper deals almost exclusively with the evaluation of the medical care process at the level of physician-patient interaction and excludes processes primarily related to the effective delivery of medical care at the community level.
...
1
2
3
4
5
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