The effectiveness of guideline implementation strategies in the dental setting: a systematic review

Abstract

BackgroundGuideline implementation has been an ongoing challenge in the dental practice setting. Despite this, there are no reviews summarising the existing evidence regarding effective guideline implementation strategies in this setting. In order to address this, this systematic review examines the effectiveness of guideline implementation strategies in the dental practice setting.MethodsA systematic search was undertaken according to the PRISMA statement across nine electronic databases, targeting randomised controlled trials and quasi-experimental studies which evaluated the effectiveness of guideline implementation strategies in improving guideline adherence in the dental setting. All records were independently examined for relevance and appraised for study quality by two authors, with consensus achieved by a third author. Data were extracted from included studies using a standardised data extraction pro forma.ResultsA total of 15 records were eligible for inclusion in this review, which focused on the effects of audit and feedback, reminders, education, patient-mediated interventions, pay for performance and multifaceted interventions. Although there were some conflicting evidence, studies within each category of implementation strategy indicated a positive effect on guideline adherence.ConclusionsThis study has identified education, reminders and multifaceted interventions as effective implementation strategies for the dental practice setting. Although this is similar to research findings from other health sectors, there is some evidence to suggest patient-mediated interventions may be less effective and pay for performance may be more effective in the dental setting. These findings can inform policy makers, professional associations, colleges and organisations in the future adoption of clinical guidelines in the dental practice setting.Trial registrationThis systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration ID CRD42018093023.

Barriers to and Facilitators of Adherence to Clinical Practice Guidelines in the Middle East and North Africa Region: A Systematic Review

“…Therefore, focusing on one barrier will result in less than the desired adherence to guidelines. Educational strategies, feedback on guideline compliance, providing reminders, institutional support, and investment in resources are examples of interventions needed for well CPGs implementation [ 33 , 34 , 35 ]. Using multifaceted strategies that target patients, clinicians, organizations, and policies is recommended [ 36 ].…”

Improving nurses’ knowledge of managing endotracheal tube cuff pressure in intensive care units: A quasi-experimental study

“…These guidelines were selected as they were developed in the context of a low- and middle-income country, considering the resource constraints experienced in this context. As the use of multifaceted; strategies, and particularly including active strategies, has proven to enhance staff compliance with evidence-based interventions in the ICU, and subsequently improved knowledge and practices in this context (Hawe et al 2009 ; Villarosa et al 2019 ), an educational intervention was developed including multiple implementation strategies with both passive and active strategies. The educational intervention consisted of a half-day educational session using a printed version of the evidence-based guidelines, a summary of these guidelines, a related algorithm, a PowerPoint presentation explaining the concepts of the guidelines and four monitoring visits.…”

“…To enhance the uptake and implementation of evidence-based guidelines, multiple strategies can be used. These strategies include passive methods, such as printed material and formal lectures, as well as active methods, such as educational sessions, audits, feedback, educational outreach visits, academic detailing and videoconferencing (Villarosa et al 2019 ).…”

Applying a scoping review approach for identifying effective implementation strategies in oral health settings

“…A few of these factors include cost of the implementation efforts, 16 likelihood of implementation success, utility of the implemented practice and coherence and fit of the new practice with the culture and or climate of the organization. 17 Our results add a level of rigor to clinical decision-making by reducing the otherwise ambiguous and resource-intensive process of identifying and selecting implementation strategies that can help health care systems effectively deliver EBPs. Engaging stakeholders in the initial steps of implementation can directly contribute to validating their views to improve implementation strategies and delivery of new practices in a real-world health care context.…”