Enhancing cancer care guideline development and implementation using
                        formal guideline adaptation: methodology description

Davies, Carmel; Summersby, Elizabeth; Clarke, Vanessa; Mooney, Gráinne; Maher, Kathy; Twohig, Mairead; Havern, Marie; Sharkey, Paula; Furlong, Eileen

doi:10.5334/ijic.s3656

Cited by 2 publications

(2 citation statements)

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“…Disconnections between the guideline recommendations and ‘real’ clinical practice (applicability issue) were identified as one of the frequently reported barriers, which could be partly addressed by using a collaborative model of codesign and coproduction (involving clinical personnel and end-users such as PCPs, managers, patients in the guideline development process). 41 In addition, a detailed description of the recommendations such as the dosage of the intervention (frequency, intensity and duration) could be another strategy to overcome the barrier of lack of clarity, specificity and applicability of CPGs. 27 30 The collaborative partnerships between researchers and clinical personnel and end-users can transcend the boundaries between research and real world, as well as promote the compatibility of the recommendations with real practice.…”

Section: Discussionmentioning

confidence: 99%

Barriers and enablers to implementing clinical practice guidelines in primary care: an overview of systematic reviews

2023

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ObjectivesTo identify the barriers and enablers to implementing clinical practice guidelines (CPGs) recommendations in primary care and to provide recommendations that could facilitate the uptake of CPGs recommendations.DesignAn overview of systematic reviews.Data sourcesNine electronic databases (PubMed, Cochrane Library, CINAHL, MEDLINE, PsycINFO, Web of Science, Journals @Ovid Full Text, EMBase, JBI) and three online data sources for guidelines (Turning Research Into Practice, the National Guideline Clearinghouse and the National Institute for Health and Care Excellence) were searched until May 2021.Eligibility criteriaSystematic reviews, meta-analyses or other types of systematic synthesis of quantitative, qualitative or mixed-methods studies on the topic of barriers and/or enablers for CPGs implementation in primary care were included.Data extraction and synthesisTwo authors independently screened the studies and extracted the data using a predesigned data extraction form. The methodological quality of the included studies was appraised by using the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. Content analysis was used to synthesise the data.ResultsTwelve systematic reviews were included. The methodological quality of the included reviews was generally robust. Six categories of barriers and enablers were identified, which include (1) political, social and culture factors, (2) institutional environment and resources factors, (3) guideline itself related factors, (4) healthcare provider-related factors, (5) patient-related factors and (6) behavioural regulation-related factors. The most commonly reported barriers within the above-mentioned categories were suboptimal healthcare networks and interprofessional communication pathways, time constraints, poor applicability of CPGs in real-world practice, lack of knowledge and skills, poor motivations and adherence, and inadequate reinforcement (eg, remuneration). Presence of technical support (‘institutional environment and resources factors’), and timely education and training for both primary care providers (PCPs) (‘healthcare provider-related factors’) and patients (‘patient-related factors’) were the frequently reported enablers.ConclusionPolicy-driven strategies should be developed to motivate different levels of implementation activities, which include optimising resources allocations, promoting integrated care models, establishing well-coordinated multidisciplinary networks, increasing technical support, encouraging PCPs and patients’ engagement in guideline development, standardising the reporting of guidelines, increasing education and training, and stimulating PCPs and patients’ motivations. All the activities should be conducted by fully considering the social, cultural and community contexts to ensure the success and sustainability of CPGs implementation.

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Section: Discussionmentioning

confidence: 99%

Barriers and enablers to implementing clinical practice guidelines in primary care: an overview of systematic reviews

2023

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“… 18 , 24 , 35–37 Engaging end-users in co-design can optimise the compatibility of GItools with the realities of clinical practice. 38 , 39 Co-design ensures recommendations are not only based on evidence for therapeutic effects but also consider practical implementation factors such as cost, time, clinical utility, and convenience. 40 …”

Section: Discussionmentioning

confidence: 99%

Translating evidence into practice in primary care management of adolescents and women with polycystic ovary syndrome: a mixed-methods study

Cowan,

Moran,

Garad

et al. 2024

Family Practice

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Background The international guideline on polycystic ovary syndrome (PCOS) provides evidence-based recommendations on the management of PCOS. Guideline implementation tools (GItools) were developed for general practitioner (GP) use to aid rapid translation of guidelines into practice. This mixed-methods study aimed to evaluate barriers and enablers of the uptake of PCOS GItools in general practice. Design and setting A cross-sectional survey was distributed through professional networks and social media to GPs and GPs in training in Australia. Survey respondents were invited to contribute to semi-structured interviews. Interviews were audio-recorded and transcribed verbatim. Qualitative data were thematically analysed and mapped deductively to the Theoretical Domains Framework and Capability, Opportunity, Motivation and Behaviour model. Results The study engaged 146 GPs through surveys, supplemented by interviews with 14 participants. A key enabler to capability was reflective practice. Barriers relating to opportunity included limited awareness and difficulty locating and using GItools due to length and lack of integration into practice software, while enablers included ensuring recommendations were relevant to GP scope of practice. Enablers relevant to motivation included co-use with patients, and evidence of improved outcomes with the use of GItools. Discussion This study highlights inherent barriers within the Australian healthcare system that hinder GPs from integrating evidence for PCOS. Findings will underpin behaviour change interventions to assist GPs in effectively utilising guidelines in clinical practice, therefore minimising variations in care. While our findings will have a direct influence on guideline translation initiatives, changes at organisational and policy levels are also needed to address identified barriers.

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Enhancing cancer care guideline development and implementation using formal guideline adaptation: methodology description

Cited by 2 publications

References 1 publication

Barriers and enablers to implementing clinical practice guidelines in primary care: an overview of systematic reviews

Barriers and enablers to implementing clinical practice guidelines in primary care: an overview of systematic reviews

Translating evidence into practice in primary care management of adolescents and women with polycystic ovary syndrome: a mixed-methods study

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