Effective implementation of research into practice: An overview of systematic reviews of the health literature

被引：165

作者：

Boaz A. ^{[1
]}

Baeza J. ^{[2
]}

Fraser A. ^{[2
]}

机构：

[1] Department of Primary Care and Public Health Sciences, King's College London, London SE1 3QD

[2] Department of Management, School of Social Science and Public Policy, King's College London, London SE1 9NH

来源：

BMC Research Notes | / 4卷 / 1期

关键词：

Systematic Review; Primary Study; Research Evidence; Opinion Leader; Strategy Type;

D O I：

10.1186/1756-0500-4-212

中图分类号：

学科分类号：

摘要：

Background: The gap between research findings and clinical practice is well documented and a range of interventions has been developed to increase the implementation of research into clinical practice. Findings. A review of systematic reviews of the effectiveness of interventions designed to increase the use of research in clinical practice. A search for relevant systematic reviews was conducted of Medline and the Cochrane Database of Reviews 1998-2009. 13 systematic reviews containing 313 primary studies were included. Four strategy types are identified: audit and feedback; computerised decision support; opinion leaders; and multifaceted interventions. Nine of the reviews reported on multifaceted interventions. This review highlights the small effects of single interventions such as audit and feedback, computerised decision support and opinion leaders. Systematic reviews of multifaceted interventions claim an improvement in effectiveness over single interventions, with effect sizes ranging from small to moderate. This review found that a number of published systematic reviews fail to state whether the recommended practice change is based on the best available research evidence. Conclusions: This overview of systematic reviews updates the body of knowledge relating to the effectiveness of key mechanisms for improving clinical practice and service development. Multifaceted interventions are more likely to improve practice than single interventions such as audit and feedback. This review identified a small literature focusing explicitly on getting research evidence into clinical practice. It emphasizes the importance of ensuring that primary studies and systematic reviews are precise about the extent to which the reported interventions focus on changing practice based on research evidence (as opposed to other information codified in guidelines and education materials). © 2011 Boaz et al; licensee BioMed Central Ltd.

引用

共 37 条

[1]

Grol R., Grimshaw J., From best evidence to best practice: Effective implementation of change in patients' care.[see comment]. [Review] [103 refs], Lancet, 362, pp. 1225-1230, (2003)

[2]

Green L.A., Seifert C.M., Translation of research into practice: Why we can't "just do it, Journal of the American Board of Family Practice, 18, 6, pp. 541-545, (2005)

[3]

Grimshaw J., McAuley L.M., Bero L., Systematic reviews of the effectiveness of quality improvement strategies and programmes, Quality & Safety in Health Care, 12, pp. 298-303, (2010)

[4]

Grimshaw J.M., Shirran L., Thomas R., Mowatt G., Fraser C., Bero L., Et al., Changing provider behavior - An overview of systematic reviews of interventions, Medical Care, 39, (2001)

[5]

Francke A.L., Smit M.C., De Veer A.J., Mistiaen P., Factors influencing the implementation of clinical guidelines for health care professionals: A systematic meta-review. [Review] [64 refs], BMC Medical Informatics & Decision Making, 8, (2008)

[6]

Thompson D.S., Estabrooks C.A., Scott-Findlay S., Moore K., Wallin L., Interventions aimed at increasing research use in nursing: A systematic review, Implementation Science, 2, (2007)

[7]

Shiffman R.N., Liaw Y., Brandt C.A., Corb G.J., Computer-based guideline implementation systems: A systematic review of functionality and effectiveness, Journal of the American Medical Informatics Association, 6, 2, pp. 104-114, (1999)

[8]

Ranji S.R., Steinman M.A., Shojania K.G., Gonzales R., Interventions to reduce unnecessary antibiotic prescribing: A systematic review and quantitative analysis (Provisional abstract), Medical Care, 46, pp. 847-862, (2008)

[9]

Van Der Wees P.J., Jamtvedt G., Rebbeck T., De Bie R.A., Dekker J., Hendriks E.J., Multifaceted strategies may increase implementation of physiotherapy clinical guidelines: A systematic review. [Review] [36 refs], Australian Journal of Physiotherapy, 54, pp. 233-241, (2008)

[10]

Stead L.F., Bergson G., Lancaster T., Physician advice for smoking cessation, Lancaster Tim Physician Advice for Smoking Cessation Cochrane Database of Systematic Reviews: Reviews 2008, 2, (2008)

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