Local opinion leaders: effects on professional practice and health care outcomes

Flodgren, Gerd; Parmelli, Elena; Doumit, Gaby; Gattellari, Melina; O'Brien, Mary Ann; Grimshaw, Jeremy; Eccles, Martin P

doi:10.1002/14651858.cd000125.pub4

Cited by 1,070Health Policy Implementation ScienceHealth Sciences Research and EducationClinical practice guidelines implementation

Local opinion leaders: effects on professional practice and health care outcomes

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Flodgren, Gerd, Parmelli, Elena, Doumit, Gaby, Gattellari, Melina, O'Brien, Mary Ann, Grimshaw, Jeremy, Eccles, Martin P·2011·Cochrane Database of Systematic Reviews

DOI 10.1002/14651858.cd000125.pub4PMC PMC4172331

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Abstract

BACKGROUND: Clinical practice is not always evidence-based and, therefore, may not optimise patient outcomes. Opinion leaders disseminating and implementing 'best evidence' is one method that holds promise as a strategy to bridge evidence-practice gaps. OBJECTIVES: To assess the effectiveness of the use of local opinion leaders in improving professional practice and patient outcomes. SEARCH STRATEGY: We searched Cochrane EPOC Group Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, HMIC, Science Citation Index, Social Science Citation Index, ISI Conference Proceedings and World Cat Dissertations up to 5 May 2009. In addition, we searched reference lists of included articles. SELECTION CRITERIA: Studies eligible for inclusion were randomised controlled trials investigating the effectiveness of using opinion leaders to disseminate evidence-based practice and reporting objective measures of professional performance and/or health outcomes. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data from each study and assessed its risk of bias. For each trial, we calculated the median risk difference (RD) for compliance with desired practice, adjusting for baseline where data were available. We reported the median adjusted RD for each of the main comparisons. MAIN RESULTS: We included 18 studies involving more than 296 hospitals and 318 PCPs. Fifteen studies (18 comparisons) contributed to the calculations of the median adjusted RD for the main comparisons. The effects of interventions varied across the 63 outcomes from 15% decrease in compliance to 72% increase in compliance with desired practice. The median adjusted RD for the main comparisons were: i) Opinion leaders compared to no intervention, +0.09; ii) Opinion leaders alone compared to a single intervention, +0.14; iii) Opinion leaders with one or more additional intervention(s) compared to the one or more additional intervention(s), +0.10; iv) Opinion leaders as part of multiple interventions compared to no intervention, +0.10. Overall, across all 18 studies the median adjusted RD was +0.12 representing a 12% absolute increase in compliance in the intervention group. AUTHORS' CONCLUSIONS: Opinion leaders alone or in combination with other interventions may successfully promote evidence-based practice, but effectiveness varies both within and between studies. These results are based on heterogeneous studies differing in terms of type of intervention, setting, and outcomes measured. In most of the studies the role of the opinion leader was not clearly described, and it is therefore not possible to say what the best way is to optimise the effectiveness of opinion leaders.

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Nilsson, G. H., Hjemdahl, P., Hassler, A., Vitols, S., Wallén, N. H., & Krakau, I. (2001) · European Journal of Clinical Pharmacology · doi:10.1007/s002280000242 · Cited by 55 · see citing works
Simulated Physician Learning Intervention to Improve Safety and Quality of Diabetes Care: A Randomized Trial
O’Connor, P. J., Sperl‐Hillen, J. M., Johnson, P. E., Rush, W. A., Asche, S. E., Dutta, P., & Biltz, G. R. (2009) · Diabetes Care · doi:10.2337/dc08-0944 · Cited by 53 · see citing works
Cost-effectiveness of a team and leaders-directed strategy to improve nurses’ adherence to hand hygiene guidelines: A cluster randomised trial
Huis, A. M. P., Hulscher, M., Adang, E., Grol, R. P. T. M., van Achterberg, T., & Schoonhoven, L. (2012) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2012.11.016 · Cited by 52 · see citing works
Multifaceted implementation of stroke prevention guidelines in primary care: cluster-randomised evaluation of clinical and cost effectiveness
Wright, J., Bibby, J., Eastham, J., Harrison, S. A., McGeorge, M., Patterson, C., Price, N., Russell, D., Russell, I. T., Small, N., et al. (2007) · BMJ Quality & Safety · doi:10.1136/qshc.2006.019778 · Cited by 51 · see citing works
Impact of opinion leader–endorsed evidence summaries on the quality of prescribing for patients with cardiovascular disease: A randomized controlled trial
Majumdar, S. R., Tsuyuki, R. T., & McAlister, F. A. (2006) · American Heart Journal · doi:10.1016/j.ahj.2006.07.030 · Cited by 47 · see citing works
Increasing smoking cessation care in a preoperative clinic: a randomized controlled trial
Wolfenden, L., Wiggers, J. H., Knight, J., Campbell, E. M., Spigelman, A. D., Kerridge, R. K., & Moore, K. (2004) · Preventive Medicine · doi:10.1016/j.ypmed.2004.11.011 · Cited by 47 · see citing works
Improving discussion of surgical treatment options for patients with breast cancer: local medical opinion leaders versus audit and performance feedback
Guadagnoli, E., Soumerai, S. B., Gurwitz, J. H., Borbas, C., Shapiro, C. L., Weeks, J. C., & Morris, N. (2000) · Breast Cancer Research and Treatment · doi:10.1023/a:1006475012861 · Cited by 45 · see citing works
Implementing evidence based antiemetic guidelines in the oncology setting: results of a 4-month prospective intervention study
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Failure to report protocol violations in clinical trials: a threat to internal validity?
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A Randomized Controlled Trial to Change Antibiotic Prescribing Patterns in a Community
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A randomized trial of strategies to increase chlamydia screening in young women
Scholes, D., Grothaus, L. C., McClure, J. B., Reid, R. J., Fishman, P. A., Sisk, C. A., Lindenbaum, J. E., Green, B. B., Grafton, J. R., & Thompson, R. S. (2006) · Preventive Medicine · doi:10.1016/j.ypmed.2006.04.019 · Cited by 43 · see citing works
Evaluation of an educational program for primary care practitioners, on the management of osteoarthritis
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Practice‐Level Effects of Interventions to Improve Asthma Care in Primary Care Settings: The Pediatric Asthma Care Patient Outcomes Research Team
Finkelstein, J. A., Lozano, P., Fuhlbrigge, A. L., Carey, V. J., Inui, T. S., Soumerai, S. B., Sullivan, S. D., Wagner, E. H., Weiss, S. T., & Weiss, K. B. (2005) · Health Services Research · doi:10.1111/j.1475-6773.2005.00451.x · Cited by 42 · see citing works
A cluster-randomized trial to improve stroke care in hospitals
Lakshminarayan, K., Borbas, C., McLaughlin, B., Morris, N. E., Vazquez, G., Luepker, R. V., & Anderson, D. C. (2010) · Neurology · doi:10.1212/wnl.0b013e3181df096b · Cited by 38 · see citing works
The employment of ward opinion leaders for continuing education in the hospital
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Quasi-Experimental designs for quality improvement research
Toulany, A., McQuillan, R., Thull‐Freedman, J. D., & Margolis, P. A. (2013) · Implementation Science · doi:10.1186/1748-5908-8-s1-s3 · Cited by 37 · see citing works
Length of hospital stay.
Jacoby, M. G., & Greaves, D. (1978) · BMJ · doi:10.1136/bmj.2.6138.705-a · Cited by 33 · see citing works
A cluster randomized controlled trial comparing three methods of disseminating practice guidelines for children with croup [ISRCTN73394937]
Johnson, D. W., Craig, W. R., Brant, R., Mitton, C., Svenson, L. W., & Klassen, T. P. (2006) · Implementation Science · doi:10.1186/1748-5908-1-10 · Cited by 31 · see citing works
The Enhancing Secondary Prevention in Coronary Artery Disease trial
McAlister, F. A., Fradette, M., Majumdar, S. R., Williams, R., Graham, M. M., McMeekin, J., Ghali, W. A., Tsuyuki, R. T., Knudtson, M. L., & Grimshaw, J. (2009) · Canadian Medical Association Journal · doi:10.1503/cmaj.090917 · Cited by 31 · see citing works
Self-citation
Educationally influential physicians: The need for construct validation
Ryan, D. P., Marlow, B. A., & Fisher, R. H. (2002) · Journal of Continuing Education in the Health Professions · doi:10.1002/chp.1340220305 · Cited by 30 · see citing works
Comparing the Efficacy of Staff Versus Housestaff Instruction in an Intervention to Improve Hypertension Management
Denton, G. D., Smith, J., Faust, J., & Holmboe, E. S. (2001) · Academic Medicine · doi:10.1097/00001888-200112000-00022 · Cited by 30 · see citing works
A trial of education, prompts, and opinion leaders to improve prescription of lipid modifying therapy by primary care physicians for patients with ischemic heart disease
Bloomfield, H. E. (2005) · BMJ Quality & Safety · doi:10.1136/qshc.2004.012617 · Cited by 30 · see citing works
A Randomized Controlled Trial to Improve Lymph Node Assessment in Stage II Colon Cancer
Wright, F. C. (2008) · Archives of Surgery · doi:10.1001/archsurg.143.11.1050 · Cited by 30 · see citing works
The cluster-randomized Quality Initiative in Rectal Cancer trial: evaluating a quality-improvement strategy in surgery
Simunovic, M. R. I., Coates, A. J., Goldsmith, C. H., Thabane, L., Reeson, D., Smith, A., McLeod, R. S., DeNardi, F. G., Whelan, T. J., & Levine, M. N. (2010) · Canadian Medical Association Journal · doi:10.1503/cmaj.091883 · Cited by 29 · see citing works
An interdisciplinary knowledge translation intervention in long-term care: Study protocol for the vitamin D and osteoporosis study (ViDOS) pilot cluster randomized controlled trial
Kennedy, C. C., Ioannidis, G., Giangregorio, L., Adachi, J. D., Thabane, L., Morin, S. N., Crilly, R. G., Marr, S., Josse, R. G., Lohfeld, L. H., et al. (2012) · Implementation Science · doi:10.1186/1748-5908-7-48 · Cited by 25 · see citing works
A controlled before–after trial of structured diabetes care in primary health centres in a newly developed country
Reed, R. L., Revel, A. D., Carter, A. O., Saadi, H., & Dunn, E. V. (2005) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzi043 · Cited by 24 · see citing works
Key Opinion Leaders and Paediatric Antidepressant Overprescribing
Jureidini, J. N., & McHenry, L. B. (2009) · Psychotherapy and Psychosomatics · doi:10.1159/000214440 · Cited by 23 · see citing works
Implementing evidence-based practice: evaluation of an opinion leader strategy to improve breast-feeding rates
Sisk, J. E., Greer, A. L., Wojtowycz, M., Pincus, L. B., & Aubry, R. H. (2004) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2003.09.014 · Cited by 23 · see citing works
Randomised controlled trial to change the hospital management of unstable angina
Heller, R. F., D’Este, C. A., Lim, L. L.-Y., O'Connell, R. L., & Powell, H. A. (2001) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.2001.tb143238.x · Cited by 23 · see citing works
Impact of an educational intervention to improve prescribing by private physicians in Uganda.
Obua, C., Ogwal-Okeng, J. W., Waako, P. J., Aupont, O., & Ross‐Degnan, D. (2004) · PubMed · Cited by 20 · see citing works
Implementation of research findings to reduce postoperative pain at night
Closs, S. J., Briggs, M., & Everitt, V. (1999) · International Journal of Nursing Studies · doi:10.1016/s0020-7489(98)00053-4 · Cited by 18 · see citing works
Randomised trial of an integrated educational strategy to reduce investigation rates in young women with dysfunctional uterine bleeding
Searle, J., Grover, S. R., Santin, A., & Weideman, P. C. (2002) · Australian and New Zealand Journal of Obstetrics and Gynaecology · doi:10.1111/j.0004-8666.2002.00397.x · Cited by 15 · see citing works
A randomized trial of an acid-peptic disease management program in a managed care environment.
Ofman, J. J., Segal, R., Russell, W. L., Cook, D. J., Sandhu, M., Maue, S. K., Lowenstein, E. H., Pourfarzib, R., Blanchette, E., Ellrodt, G. A., et al. (2003) · PubMed · Cited by 13 · see citing works
Lake Superior Rural Cancer Care Project. Part II: Provider Knowledge
Elliott, T. E., Elliott, B. A., Regal, R. R., Renier, C. M., Crouse, B. J., Gangeness, D. E., Witrak, M. T., & Jensen, P. B. (2001) · Cancer Practice · doi:10.1046/j.1523-5394.2001.91007.x · Cited by 9 · see citing works
Effectiveness of a clinical practice guideline implementation strategy for patients with anxiety disorders in primary care: cluster randomized trial
Tello-Bernabé, E., Sanz‐Cuesta, T., del Cura-González, I., de Santiago-Hernando, M. L., Jurado-Sueiro, M., Girón, M. F., de Blas, F. G., Pensado-Freire, H., Maldonado, F. G., de la Puente-Chamorro, M. J., et al. (2011) · Implementation Science · doi:10.1186/1748-5908-6-123 · Cited by 6 · see citing works
RESEARCH LETTER: Uptake of research findings into clinical practice: a controlled study of the impact of a brief external intervention on the use of corticosteroids in preterm delivery
Mant, J., Hicks, N., Dopson, S., & Hurley, P. A. (1999) · Journal of Evaluation in Clinical Practice · doi:10.1046/j.1365-2753.1999.00169.x · Cited by 5 · see citing works

Flagged first, then by citations

1 of the 117 references couldn’t be matched to a known paper.

Research works printed but not linked: 5

Hodnett ED Kaufmann K O’Brien-Pallas L Chipman M Watson-MacDonell J Hunsberger W A strategy to promote research-based nursing care: effects on childbirth outcomes Research in Nursing and Health 1996 19 13 20 8552798
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Doumit G Grimshaw J Graham I Smith A Wright F Opinion leaders - Effectiveness, Identification, Stability, Specificity, and Mechanism of Action Master Thesis 2006 University of Ottawa Ottawa, Canada
Hiss RG MacDonald R David WR Identification of physician educational influentials in small community hospitals 283 8 Proceedings of the Seventeenth Annual Conference on Research in Medical Education Washington DC 1978
Doumit G Gattellari M Grimshaw J O’Brien NMA Local opinion leaders: effects on professional practice and heath care outcomes Cochrane Database of Systematic Reviews 2007 1 DOI: 10.1002/14651858.MR000006.pub3 · DOI · Paper page

Sorted by citations

Diffusion of Innovations in Service Organizations: Systematic Review and Recommendations
GREENHALGH, T., ROBERT, G., MACFARLANE, F., BATE, P., & KYRIAKIDOU, O. (2004) · The Milbank Quarterly · doi:10.1111/j.0887-378x.2004.00325.x · Cited by 7,448 · see citing works
Audit and feedback: effects on professional practice and healthcare outcomes
Ivers, N., Jamtvedt, G., Flottorp, S., Young, J. M., Odgaard-Jensen, J., French, S. D., O'Brien, M. A., Johansen, M., Grimshaw, J., & Oxman, A. D. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000259.pub3 · Cited by 5,485 · see citing works
Self-citation
The updated consolidated framework for implementation research based on user feedback
Damschroder, L. J., Reardon, C. M., Widerquist, M. A. O., & Lowery, J. (2022) · Implementation Science · doi:10.1186/s13012-022-01245-0 · Cited by 4,452 · see citing works
Implementation strategies: recommendations for specifying and reporting
Proctor, E. K., Powell, B. J., & McMillen, J. C. (2013) · Implementation Science · doi:10.1186/1748-5908-8-139 · Cited by 2,585 · see citing works
Knowledge translation of research findings
Grimshaw, J. M., Eccles, M. P., Lavis, J. N., Hill, S. J., & Squires, J. E. (2012) · Implementation Science · doi:10.1186/1748-5908-7-50 · Cited by 2,407 · see citing works
Self-citation
Influentials, Networks, and Public Opinion Formation
Watts, D. J., & Dodds, P. S. (2007) · Journal of Consumer Research · doi:10.1086/518527 · Cited by 1,864 · see citing works
Continuing education meetings and workshops: effects on professional practice and health care outcomes
Forsetlund, L., Bjørndal, A., Rashidian, A., Jamtvedt, G., O'Brien, M. A., Wolf, F. M., Davis, D., Odgaard-Jensen, J., & Oxman, A. D. (2009) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003030.pub2 · Cited by 1,849 · see citing works
Self-citation
PARIHS revisited: from heuristic to integrated framework for the successful implementation of knowledge into practice
Harvey, G., & Kitson, A. (2015) · Implementation Science · doi:10.1186/s13012-016-0398-2 · Cited by 1,271 · see citing works
Best care at lower cost: the path to continuously learning health care in America
Smith, M. A., Saunders, R., Stuckhardt, L., & McGinnis, J. M. (2014) · Choice Reviews Online · doi:10.5860/choice.51-3277 · Cited by 1,356 · see citing works
Educational outreach visits: effects on professional practice and health care outcomes
O'Brien, M. A., Rogers, S., Jamtvedt, G., Oxman, A. D., Odgaard-Jensen, J., Kristoffersen, D. T., Forsetlund, L., Bainbridge, D., Freemantle, N., Davis, D., et al. (2007) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000409.pub2 · Cited by 1,279 · see citing works
Self-citation
Planning and Studying Improvement in Patient Care: The Use of Theoretical Perspectives
GROL, R. P. T. M., BOSCH, M. C., HULSCHER, M. E. J. L., ECCLES, M. P., & WENSING, M. (2007) · The Milbank Quarterly · doi:10.1111/j.1468-0009.2007.00478.x · Cited by 943 · see citing works
Self-citation
Current evidence on risk factors for knee osteoarthritis in older adults: a systematic review and meta-analysis
Silverwood, V., Bucknall, M., Jinks, C., Jordan, J. L., Protheroe, J., & Jordan, K. P. (2014) · Osteoarthritis and Cartilage · doi:10.1016/j.joca.2014.11.019 · Cited by 948 · see citing works
Barriers and Strategies in Guideline Implementation—A Scoping Review
Fischer, F., Lange, K., Klose, K., Greiner, W., & Kraemer, A. (2016) · Healthcare · doi:10.3390/healthcare4030036 · Cited by 906 · see citing works
Enhancing the Impact of Implementation Strategies in Healthcare: A Research Agenda
Powell, B. J., Fernandez, M. E., Williams, N. J., Aarons, G. A., Beidas, R. S., Lewis, C. C., McHugh, S. M., & Weiner, B. J. (2019) · Frontiers in Public Health · doi:10.3389/fpubh.2019.00003 · Cited by 775 · see citing works
Printed educational materials: effects on professional practice and healthcare outcomes
Giguere, A. M. C., Légaré, F., Grimshaw, J., Turcotte, S., Fiander, M., Grudniewicz, A., Makosso‐Kallyth, S., Wolf, F. M., Farmer, A. P., & Gagnon, M. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004398.pub3 · Cited by 879 · see citing works
Self-citation
Using Normalization Process Theory in feasibility studies and process evaluations of complex healthcare interventions: a systematic review
May, C. R., Cummings, A., Girling, M., Bracher, M., Mair, F. S., May, C. M., Murray, E., Myall, M., Rapley, T., & Finch, T. (2018) · Implementation Science · doi:10.1186/s13012-018-0758-1 · Cited by 683 · see citing works
Interventions to improve antibiotic prescribing practices in ambulatory care
Arnold, S. R., & Straus, S. E. (2005) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003539.pub2 · Cited by 716 · see citing works
Promoting professional behaviour change in healthcare: what interventions work, and why? A theory-led overview of systematic reviews
Johnson, M. J., & May, C. R. (2015) · BMJ Open · doi:10.1136/bmjopen-2015-008592 · Cited by 512 · see citing works
Stillbirths: the way forward in high-income countries.
Flenady, V., Middleton, P., Smith, G. C. S., Duke, W., Erwich, J., Khong, T., Neilson, J., Ezzati, M., Koopmans, L., Ellwood, D., et al. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60064-0 · Cited by 470 · see citing works
Effects of continuing medical education on improving physician clinical care and patient health: A review of systematic reviews
Bloom, B. S. (2005) · International Journal of Technology Assessment in Health Care · doi:10.1017/s026646230505049x · Cited by 478 · see citing works
How can we improve guideline use? A conceptual framework of implementability
Gagliardi, A. R., Brouwers, M. C., Palda, V. A., Lemieux‐Charles, L., & Grimshaw, J. (2011) · Implementation Science · doi:10.1186/1748-5908-6-26 · Cited by 469 · see citing works
Self-citation
Implementation of Evidence-based Practice in Child Welfare: Service Provider Perspectives
Aarons, G. A., & Palinkas, L. A. (2007) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-007-0121-3 · Cited by 450 · see citing works
A guiding framework and approach for implementation research in substance use disorders treatment.
Damschroder, L. J., & Hagedorn, H. J. (2011) · Psychology of Addictive Behaviors · doi:10.1037/a0022284 · Cited by 427 · see citing works
No more ‘business as usual’ with audit and feedback interventions: towards an agenda for a reinvigorated intervention
Ivers, N. M., Sales, A., Colquhoun, H., Michie, S., Foy, R., Francis, J. J., & Grimshaw, J. M. (2014) · Implementation Science · doi:10.1186/1748-5908-9-14 · Cited by 400 · see citing works
Self-citation
Toward the integration of education and mental health in schools
Atkins, M. S., Hoagwood, K. E., Kutash, K., & Seidman, E. (2010) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-010-0299-7 · Cited by 422 · see citing works
Implementation of evidence-based treatment protocols to manage fever, hyperglycaemia, and swallowing dysfunction in acute stroke (QASC): a cluster randomised controlled trial
Middleton, S., McElduff, P., Ward, J., Grimshaw, J., Dale, S., D’Este, C. A., Drury, P., Griffiths, R., Cheung, N. W., Quinn, C., et al. (2011) · The Lancet · doi:10.1016/s0140-6736(11)61485-2 · Cited by 420 · see citing works
Self-citation
Growing Literature, Stagnant Science? Systematic Review, Meta-Regression and Cumulative Analysis of Audit and Feedback Interventions in Health Care
Ivers, N. M., Grimshaw, J., Jamtvedt, G., Flottorp, S. A., O’Brien, M. A., French, S. D., Young, J. M., & Odgaard‐Jensen, J. (2014) · Journal of General Internal Medicine · doi:10.1007/s11606-014-2913-y · Cited by 383 · see citing works
Self-citation
Multicentre, cluster-randomized clinical trial of algorithms for critical-care enteral and parenteral therapy (ACCEPT).
Martin, C. M., Doig, G. S., Heyland, D. K., Morrison, T., & Sibbald, W. J. (2004) · PubMed Central · Cited by 380 · see citing works
Are multifaceted interventions more effective than single-component interventions in changing health-care professionals' behaviours? An overview of systematic reviews
Squires, J. E., Sullivan, K., Eccles, M. P., Worswick, J., & Grimshaw, J. M. (2014) · Implementation Science · doi:10.1186/s13012-014-0152-6 · Cited by 368 · see citing works
Self-citation
Clarifying the concepts in knowledge transfer: a literature review
Thompson, G. N., Estabrooks, C. A., & Degner, L. F. (2006) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2006.03775.x · Cited by 363 · see citing works
Effect of point-of-care computer reminders on physician behaviour: a systematic review
Shojania, K. G., Jennings, A., Mayhew, A., Ramsay, C. R., Eccles, M., & Grimshaw, J. (2010) · Canadian Medical Association Journal · doi:10.1503/cmaj.090578 · Cited by 338 · see citing works
Self-citation
Social Learning and Incentives for Experimentation and Communication
BenYishay, A., & Mobarak, A. M. (2019) · The Review of Economic Studies · doi:10.1093/restud/rdy039 · Cited by 328 · see citing works
Factors Influencing Best‐Practice Guideline Implementation: Lessons Learned from Administrators, Nursing Staff, and Project Leaders
Ploeg, J., Davies, B., Edwards, N. C., Gifford, W., & Elliott-Miller, P. (2007) · Worldviews on Evidence-Based Nursing · doi:10.1111/j.1741-6787.2007.00106.x · Cited by 320 · see citing works
Why (we think) facilitation works: insights from organizational learning theory
Berta, W., Cranley, L., Dearing, J. W., Dogherty, E. J., Squires, J. E., & Estabrooks, C. A. (2015) · Implementation Science · doi:10.1186/s13012-015-0323-0 · Cited by 286 · see citing works
Computerized clinical decision support for prescribing: provision does not guarantee uptake
Moxey, A., Robertson, J., Newby, D., Hains, I., Williamson, M., & Pearson, S.-A. (2010) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m3170 · Cited by 305 · see citing works
How Health Care Professionals Use Social Media to Create Virtual Communities: An Integrative Review
Rolls, K., Hansen, M. M., Jackson, D. W., & Elliott, D. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.5312 · Cited by 295 · see citing works
Achieving change in primary care—effectiveness of strategies for improving implementation of complex interventions: systematic review of reviews
Lau, R., Stevenson, F., Ong, B. N., Dziedzic, K., Treweek, S., Eldridge, S., Everitt, H., Kennedy, A., Qureshi, N., Rogers, A., et al. (2015) · BMJ Open · doi:10.1136/bmjopen-2015-009993 · Cited by 254 · see citing works
“Similarly, two trials compared opinion leaders alone to other strategies (standardised lectures and audit and feedback) and found a 14% absolute increase in adherence to desired practice for opinion leaders alone.(65) No conclusions could be drawn from the limited evidence.”
Result
Methods for designing interventions to change healthcare professionals’ behaviour: a systematic review
Colquhoun, H. L., Squires, J. E., Kolehmainen, N., Fraser, C., & Grimshaw, J. M. (2017) · Implementation Science · doi:10.1186/s13012-017-0560-5 · Cited by 283 · see citing works
Self-citation
Barriers to Primary Care Clinician Adherence to Clinical Guidelines for the Management of Low Back Pain: A Systematic Review and Metasynthesis of Qualitative Studies
Slade, S. C., Kent, P., Patel, S., Bucknall, T., & Buchbinder, R. (2016) · The Clinical Journal of Pain · doi:10.1097/ajp.0000000000000324 · Cited by 261 · see citing works
Continuing education meetings and workshops: effects on professional practice and healthcare outcomes
Forsetlund, L., O’Brien, M. A., Forsén, L., Mwai, L., Reinar, L. M., Okwen, P., Horsley, T., & Rose, C. J. (2021) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003030.pub3 · Cited by 293 · see citing works
Self-citation
A prescription for cultural competence in medical education
Kripalani, S., Bussey-Jones, J., Katz, M. G., & Genao, I. (2006) · Journal of general internal medicine · doi:10.1111/j.1525-1497.2006.00557.x · Cited by 262 · see citing works
Local opinion leaders: effects on professional practice and healthcare outcomes
Flodgren, G., O’Brien, M. A., Parmelli, E., & Grimshaw, J. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000125.pub5 · Cited by 262 · see citing works
Self-citation
Implementation strategies for health systems in low-income countries: an overview of systematic reviews
Tomás Pantoja, C., Opiyo, N., Lewin, S. A., Paulsen, E., Ciapponi, A., Wiysonge, C. S., Herrera, C. A., Gabriel Rada, G., Peñaloza, B., Dudley, L., et al. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011086.pub2 · Cited by 258 · see citing works
Providing education on evidence-based practice improved knowledge but did not change behaviour: a before and after study
McCluskey, A., & Lovarini, M. (2005) · BMC Medical Education · doi:10.1186/1472-6920-5-40 · Cited by 246 · see citing works
Effective implementation of research into practice: an overview of systematic reviews of the health literature
the European Implementation Score Collaborative Group (EIS), Boaz, A., Baeza, J. I., & Fraser, A. (2011) · BMC Research Notes · doi:10.1186/1756-0500-4-212 · Cited by 239 · see citing works
Translating what we have learned into practice
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Authors: Flodgren, G., Parmelli, E., Doumit, G., Gattellari, M., O'Brien, M. A., Grimshaw, J., & Eccles, M. P.
Affiliations: University of Oxford (GB)
University of Modena and Reggio Emilia (IT)
Cleveland Clinic (US)
UNSW Sydney (AU)
McMaster University; School of Rehabilitation Science, Institute for Applied Health Sciences, Faculty of Health Sciences; 1400 Main Street West Room 403 Hamilton Ontario Canada L8S 1C7
Ottawa Health Research Institute; Clinical Epidemiology Program; 1053 Carling Avenue Ottawa ON Canada K1Y 4E9
Newcastle University (GB)
ORCID: Flodgren, Gerd
Parmelli, Elena
Doumit, Gaby
Gattellari, Melina
Grimshaw, Jeremy
Venue: Cochrane Database of Systematic Reviews
Publisher: Wiley
Published: 2011-08-10
Volume: 6
Issue: 8
Pages: CD000125-CD000125
ISSN: 1361-6137 (ISSN-L)
1465-1858
DOI: 10.1002/14651858.cd000125.pub4
PMC: PMC4172331
OpenAlex: W1656816330
Cited by: 1,070
References: 117
Citations by year: 2026: 4 · 2025: 25 · 2024: 33 · 2023: 57 · 2022: 52 · 2021: 62 · 2020: 59 · 2019: 52 · 2018: 51 · 2017: 57 · 2016: 53 · 2015: 64 · 2014: 71 · 2013: 69 · 2012: 55
FWCI: 13.05
Type: journal article
Language: en
Update notices: new_version (2019-06-24)
Open access: green
www.ncbi.nlm.nih.gov
Locations: Cochrane Database of Systematic Reviews (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
Newcastle University ePrints (Newcastle Univesity)
Funders: National Institute for Health and Care Research (10/4001/03)
Topics: Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
Keywords: opinion leaders, evidence-based practice, knowledge-practice gap, professional practice change, health care outcomes, clinical teaching, primary care, hospital care, patient outcomes, evidence dissemination, health professions education, patient safety, quality of care, health professional confidence
MeSH terms: Humans, Leadership, Practice Patterns, Physicians', Policy Making, Professional Practice, Randomized Controlled Trials as Topic, Process Assessment, Health Care, Evidence-Based Medicine, Information Dissemination

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