When is audit and feedback effective in dementia care? A systematic review
Open accessAbstract
Background Evidence-based care for people with dementia is a priority for patients, carers and clinicians and a policy priority. There is evidence that people with dementia do not always receive such care. Audit and feedback, also known as clinical audit, is an extensively-used intervention to improve care. However, there is uncertainty about the best way to use it.Objectives To investigate whether audit and feedback is effective for improving health professionals' care of people with dementia. To investigate whether the content and delivery of audit and feedback affects its effectiveness in the context of health professionals' care for people with dementia.Design Systematic review DATA SOURCES: The Cochrane Central Register of Controlled Trials, Prospero, Medline (1946-December week 1 2016), PsycInfo (1967-January 2017), Cinahl (1982-January 2017), HMIC (1979-January 2017), Embase (1974-2017 week 1) databases and the Science Citation Index and Social Science Citation Index were searched combining terms for audit and feedback, health personnel, and dementia.Review methods Following screening, the data were extracted using the Template for Intervention Description and Replication (TIDieR), and synthesised graphically using harvest plots and narratively.Results Thirteen studies met the inclusion criteria. Published studies of audit and feedback in dementia rarely described more than one cycle. None of the included studies had a comparison group: 12 were before and after designs and one was an interrupted time series without a comparison group. The median absolute improvement was greater than in studies beyond dementia which have used stronger designs with fewer risks of bias. Included studies demonstrated large variation in the effectiveness of audit and feedback.Conclusions Whilst methodological and reporting limitations in the included studies hinder the ability to draw strong conclusions on the effectiveness of audit and feedback in dementia care, the large interquartile range indicates further work is needed to understand the factors which affect the effectiveness of this much-used intervention.
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Much of the evidence for individual or groups of ERIC strategies remains narrowly focused, with prior systematic reviews and meta-analyses generally focusing on a specific strategy, subpopulation, disease, outcome, service setting, or geography.
“However, much of the evidence for individual or groups of ERIC strategies remains narrowly focused. Prior systematic reviews and meta-analyses have assessed strategy effectiveness, but have generally focused on a specific strategy, (e.g., Audit and Provide Feedback) [14–16], subpopulation, disease (e.g., individuals living with dementia) [16], outcome [15], service setting (e.g., primary care Clin”
From A systematic review of experimentally tested implementation strategies across health and human service settings: evidence from 2010-2022 (2024) · cites this paper as [16]
Cites
Hoffmann, T. C., Glasziou, P. P., Boutron, I., Milne, R., Perera, R., Moher, D., Altman, D. G., Barbour, V., Macdonald, H., Johnston, M., et al. (2014) · BMJ · doi:10.1136/bmj.g1687 · Cited by 10,548 · see citing works
Audit and feedback: effects on professional practice and health care outcomes
Jamtvedt, G., Young, J. M., Kristoffersen, D. T., O'Brien, M. A., & Oxman, A. D. (2006) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000259.pub2 · Cited by 912 · cited 1× · see citing works
“The absolute improvement from audit and feedback in the present review is much larger than that identified in previous systematic reviews (Ivers et al., 2012; Jamtvedt et al., 2003; Thomson Obrien et al., 2003), the most recent of which found 4.3% absolute improvement (interquartile range 0.5–16%).”
ResultInfluentialForbes, D., Blake, C. M., Thiessen, E. J., Peacock, S., & Hawranik, P. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003946.pub4 · Cited by 194 · cited 1× · see citing works
“The search strategy was adapted from previous reviews (Ivers et al., 2012; Forbes et al., 2014).”
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Ashcraft, L. E., Goodrich, D. E., Hero, J., Phares, A., Bachrach, R. L., Quinn, D. A., Qureshi, N., Ernecoff, N. C., Lederer, L. G., Scheunemann, L. P., et al. (2024) · Implementation Science · doi:10.1186/s13012-024-01369-5 · Cited by 89 · see citing works
- Authors
- Sykes, M. J., McAnuff, J., & Kolehmainen, N.
- Affiliations
- Newcastle University (GB)
- Corresponding author
- Sykes, Michael J.
- Venue
- International Journal of Nursing Studies
- Publisher
- Elsevier BV
- Published
- 2018-03
- Volume
- 79
- Pages
- 27-35
- ISSN
- 0020-7489 (ISSN-L)
- OpenAlex
- W2766168957
- Cited by
- 19
- References
- 3
- Citations by year
- 2024: 12 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 1
- FWCI
- 0.14
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- International Journal of Nursing Studies (publishedVersion)
- PubMed (publishedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- National Institute for Health Research (NIHR)
- Health Education England/National Institute for Health Research (CDRF 2014-05-043)
- National Institute for Health Research (CDRF 2014-05-043)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- audit and feedback, clinical audit, dementia care, healthcare workers, quality of care, evidence-based care, intervention effectiveness, methodological quality, reporting quality
- MeSH terms
- Dementia, Feedback, Humans, Medical Audit, Uncertainty
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