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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Guideline uptake is influenced by six implementability domains for creating and communicating guidelines: A realist review
Journal of Clinical Epidemiology, Volume 68, No. 5, Year 2015
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Description
Objectives To identify factors associated with the implementability of clinical practice guidelines (CPGs) and to determine what characteristics improve their uptake. Study Design and Setting We conducted a realist review, which involved searching multiple sources (eg, databases, experts) to determine what about guideline implementability works, for whom, and under what circumstances. Two sets of reviewers independently screened abstracts and extracted data from 278 included studies. Analysis involved the development of a codebook of definitions, validation of data, and development of hierarchical narratives to explain guideline implementability. Results We found that guideline implementability is associated with two broad goals in guideline development: (1) creation of guideline content, which involves addressing the domains of stakeholder involvement in CPGs, evidence synthesis, considered judgment (eg, clinical applicability), and implementation feasibility and (2) the effective communication of this content, which involves domains related to fine-tuning the CPG's message (using simple, clear, and persuasive language) and format. Conclusion Our work represents a comprehensive and interdisciplinary effort toward better understanding, which attributes of guidelines have the potential to improve uptake in clinical practice. We also created codebooks and narratives of key concepts, which can be used to create tools for developing better guidelines to promote better care. © 2015 The Authors.
Authors & Co-Authors
Graham, Ian D.
Canada, Ottawa
University of Ottawa
Straus, Sharon E.
Canada, Toronto
Li ka Shing Knowledge Institute
Canada, Toronto
Keenan Research Centre for Biomedical Science
Canada, Toronto
University of Toronto
Zwarenstein, Merrick F.
Canada, London
Western University
Brouwers, Melissa C.
Canada, Hamilton
Escarpment Cancer Research Institute
Statistics
Citations: 117
Authors: 4
Affiliations: 6
Identifiers
Doi:
10.1016/j.jclinepi.2014.12.013
ISSN:
08954356
Study Approach
Systematic review