Effectiveness of guideline dissemination and implementation strategies on health care professionals’ behaviour and patient outcomes in the cancer care context: a systematic review
Open accessAbstract
Background: Health care professionals (HCPs) use clinical practice guidelines (CPGs) to make evidence-informed decisions regarding patient care. Although a large number of cancer-related CPGs exist, it is unknown which CPG dissemination and implementation strategies are effective for improving HCP behaviour and patient outcomes in a cancer care context. This review aimed to determine the effectiveness of CPG dissemination and/or implementation strategies among HCPs in a cancer care context. Methods: A comprehensive search of five electronic databases was conducted. Studies were limited to the dissemination and/or implementation of a CPG targeting both medical and/or allied HCPs in cancer care. Two reviewers independently coded strategies using the Mazza taxonomy, extracted study findings, and assessed study quality. Results: The search strategy identified 33 studies targeting medical and/or allied HCPs. Across the 33 studies, 23 of a possible 49 strategies in the Mazza taxonomy were used, with a mean number of 3.25 (SD = 1.45) strategies per intervention. The number of strategies used per intervention was not associated with positive outcomes. Educational strategies ( n = 24), feedback on guideline compliance ( n = 11), and providing reminders ( n = 10) were the most utilized strategies. When used independently, providing reminders and feedback on CPG compliance corresponded with positive significant changes in outcomes. Further, when used as part of multi-strategy interventions, group education and organizational strategies (e.g. creation of an implementation team) corresponded with positive significant changes in outcomes. Conclusions: Future CPG dissemination and implementation interventions for cancer care HCPs may benefit from utilizing the identified strategies. Research in this area should aim for better alignment between study objectives, intervention design, and evaluation measures, and should seek to incorporate theory in intervention design, so that behavioural antecedents are considered and measured; doing so would enhance the field’s understanding of the causal mechanisms by which interventions lead, or do not lead, to changes in outcomes at all levels.
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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 [18]
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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
- Tomasone, J. R., Kauffeldt, K. D., Chaudhary, R., & Brouwers, M. C.
- Affiliations
- Queen's University (CA)
- University of Toronto (CA)
- University of Ottawa (CA)
- Corresponding author
- Tomasone, Jennifer R.
- Venue
- Implementation Science
- Published
- 2020-06-03
- Volume
- 15
- Issue
- 1
- Pages
- 41-41
- ISSN
- 1748-5908 (ISSN-L)
- PMC
- PMC7268663
- OpenAlex
- W3032249524
- Cited by
- 103
- References
- 57
- Citations by year
- 2026: 8 · 2025: 12 · 2024: 40 · 2023: 12 · 2022: 16 · 2021: 10 · 2020: 5
- FWCI
- 1.80
- Type
- journal article
- Language
- en
- Update notices
- correction (2021-06-02)
- Open access
- gold
- doi.org
- Locations
- Implementation Science (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- QSpace (Queen's University Library) (submittedVersion, cc-by)
- uO Research (University of Ottawa) (submittedVersion, public-domain)
- TSpace (University of Toronto) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Canadian Institutes of Health Research (TGF97068)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
- Keywords
- guideline dissemination, guideline implementation, cancer care, healthcare workers, professional conduct, patient outcomes, reminders, educational strategies, organizational strategy, implementation strategies
- MeSH terms
- Formative Feedback, Implementation Science, Attitude of Health Personnel, Clinical Trials as Topic, Patient Care, Health Education, Humans, Health Knowledge, Attitudes, Practice, Neoplasms, Reminder Systems, Practice Guidelines as Topic, Guideline Adherence, Quality Indicators, Health Care, Information Dissemination
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