Strategies for the implementation of clinical practice guidelines in public health: an overview of systematic reviews

Detalhes bibliográficos
Autor(a) principal: Pereira, Viviane Cássia
Data de Publicação: 2022
Outros Autores: Silva, Sara N., Carvalho, Viviane Karoline da Silva, Zanghelini, Fernando, Barreto, Jorge Otávio Maia
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/59208
Resumo: Ministério da Saúde do Brasil (TED-MS-FIOCRUZ nº 43/2016)
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spelling Pereira, Viviane CássiaSilva, Sara N.Carvalho, Viviane Karoline da SilvaZanghelini, FernandoBarreto, Jorge Otávio Maia2023-06-27T21:24:10Z2023-06-27T21:24:10Z2022PEREIRA, Viviane C. et al. Strategies for the implementation of clinical practice guidelines in public health: an overview of systematic reviews. Health Research Policy and Systems, [s.l.], v. 20, n. 13, p. 1-21, jan. 2022.1478-4505https://www.arca.fiocruz.br/handle/icict/5920810.1186/s12961-022-00815-4Ministério da Saúde do Brasil (TED-MS-FIOCRUZ nº 43/2016)Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil.Ministério da Saúde. Brasília, DF, Brasil.Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil.Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil.Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil.Background: As a source of readily available evidence, rigorously synthesized and interpreted by expert clinicians and methodologists, clinical guidelines are part of an evidence-based practice toolkit, which, transformed into practice recommendations, have the potential to improve both the process of care and patient outcomes. In Brazil, the process of development and updating of the clinical guidelines for the Brazilian Unified Health System (Sistema Único de Saúde, SUS) is already well systematized by the Ministry of Health. However, the implementation process of those guidelines has not yet been discussed and well structured. Therefore, the first step of this project and the primary objective of this study was to summarize the evidence on the effectiveness of strategies used to promote clinical practice guideline implementation and dissemination. Methods: This overview used systematic review methodology to locate and evaluate published systematic reviews regarding strategies for clinical practice guideline implementation and adhered to the PRISMA guidelines for systematic review (PRISMA). Results: This overview identified 36 systematic reviews regarding 30 strategies targeting healthcare organizations, healthcare providers and patients to promote guideline implementation. The most reported interventions were educational materials, educational meetings, reminders, academic detailing and audit and feedback. Care pathways— single intervention, educational meeting—single intervention, organizational culture, and audit and feedback—both strategies implemented in combination with others—were strategies categorized as generally effective from the systematic reviews. In the meta-analyses, when used alone, organizational culture, educational intervention and reminders proved to be effective in promoting physicians’ adherence to the guidelines. When used in conjunction with other strategies, organizational culture also proved to be effective. For patient-related outcomes, education intervention showed effective results for disease target results at a short and long term. Conclusion: This overview provides a broad summary of the best evidence on guideline implementation. Even if the included literature highlights the various limitations related to the lack of standardization, the methodological quality of the studies, and especially the lack of conclusion about the superiority of one strategy over another, the summary of the results provided by this study provides information on strategies that have been most widely studied in the last few years and their effectiveness in the context in which they were applied. Therefore, this panorama can support strategy decision-making adequate for SUS and other health systems, seeking to positively impact on the appropriate use of guidelines, healthcare outcomes and the sustainability of the SUS.engSpringer NatureHealth SystemsGuidelines as TopicHealth StrategiesGuidelinesGuideline implementationHealth systemSistemas de SaúdeGuias como AssuntoEstratégias de SaúdeStrategies for the implementation of clinical practice guidelines in public health: an overview of systematic reviewsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; 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dc.title.en_US.fl_str_mv Strategies for the implementation of clinical practice guidelines in public health: an overview of systematic reviews
title Strategies for the implementation of clinical practice guidelines in public health: an overview of systematic reviews
spellingShingle Strategies for the implementation of clinical practice guidelines in public health: an overview of systematic reviews
Pereira, Viviane Cássia
Health Systems
Guidelines as Topic
Health Strategies
Guidelines
Guideline implementation
Health system
Sistemas de Saúde
Guias como Assunto
Estratégias de Saúde
title_short Strategies for the implementation of clinical practice guidelines in public health: an overview of systematic reviews
title_full Strategies for the implementation of clinical practice guidelines in public health: an overview of systematic reviews
title_fullStr Strategies for the implementation of clinical practice guidelines in public health: an overview of systematic reviews
title_full_unstemmed Strategies for the implementation of clinical practice guidelines in public health: an overview of systematic reviews
title_sort Strategies for the implementation of clinical practice guidelines in public health: an overview of systematic reviews
author Pereira, Viviane Cássia
author_facet Pereira, Viviane Cássia
Silva, Sara N.
Carvalho, Viviane Karoline da Silva
Zanghelini, Fernando
Barreto, Jorge Otávio Maia
author_role author
author2 Silva, Sara N.
Carvalho, Viviane Karoline da Silva
Zanghelini, Fernando
Barreto, Jorge Otávio Maia
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Pereira, Viviane Cássia
Silva, Sara N.
Carvalho, Viviane Karoline da Silva
Zanghelini, Fernando
Barreto, Jorge Otávio Maia
dc.subject.mesh.en_US.fl_str_mv Health Systems
Guidelines as Topic
Health Strategies
topic Health Systems
Guidelines as Topic
Health Strategies
Guidelines
Guideline implementation
Health system
Sistemas de Saúde
Guias como Assunto
Estratégias de Saúde
dc.subject.en.en_US.fl_str_mv Guidelines
Guideline implementation
Health system
dc.subject.decs.en_US.fl_str_mv Sistemas de Saúde
Guias como Assunto
Estratégias de Saúde
description Ministério da Saúde do Brasil (TED-MS-FIOCRUZ nº 43/2016)
publishDate 2022
dc.date.issued.fl_str_mv 2022
dc.date.accessioned.fl_str_mv 2023-06-27T21:24:10Z
dc.date.available.fl_str_mv 2023-06-27T21:24:10Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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status_str publishedVersion
dc.identifier.citation.fl_str_mv PEREIRA, Viviane C. et al. Strategies for the implementation of clinical practice guidelines in public health: an overview of systematic reviews. Health Research Policy and Systems, [s.l.], v. 20, n. 13, p. 1-21, jan. 2022.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/59208
dc.identifier.issn.en_US.fl_str_mv 1478-4505
dc.identifier.doi.none.fl_str_mv 10.1186/s12961-022-00815-4
identifier_str_mv PEREIRA, Viviane C. et al. Strategies for the implementation of clinical practice guidelines in public health: an overview of systematic reviews. Health Research Policy and Systems, [s.l.], v. 20, n. 13, p. 1-21, jan. 2022.
1478-4505
10.1186/s12961-022-00815-4
url https://www.arca.fiocruz.br/handle/icict/59208
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Springer Nature
publisher.none.fl_str_mv Springer Nature
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
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