Applying the RE-AIM Framework to Evaluate the Dissemination and Implementation of Clinical Practice Guidelines for Sexually Transmitted Infections

Introduction: Sexually transmitted infections are a public health problem worldwide. Their inadequate antimicrobial management has been associated with a higher risk of recurrence. Objective: To characterize the main sexually transmitted infections, the adherence to clinical practice guidelines in Colombia, and the factors associated with recurrence. Materials and methods: This observational study identified the main sexually transmitted infections, sociodemographic variables, and pharmacological management in a patient cohort from a population database of 6.5 million people affiliated with the Colombian Health System. A multivariate analysis was performed to identify variables associated with recurrence. Results: A total of 3158 patients were identified, with a mean age of 41.8 ± 14.5 years, and 63.1% were men. There were 4030 episodes of sexually transmitted infections, predominantly urethral syndrome (27.5%). Only 13.6% of patients with urethral syndrome, ulcerative syndrome, or genital warts were managed in compliance with clinical practice guidelines. A total of 20.6% of patients were dispensed condoms. A total of 16.7% of all patients had recurrences, and being male (OR:1.32; 95%CI:1.08-1.63), being <30 years old (OR:1.72; 95%CI:1.40-2.13), being treated in municipalities other than capital cities (OR:1.43; 95%CI:1.06-1.94), and having received inadequate treatment for the first episode (OR:1.93; 95%CI:1.52-2.39) were associated with recurrence. Conclusions: The majority of patients with sexually transmitted infections were not treated in compliance with clinical practice guidelines, and those who did not have adequate management had a higher risk of recurrence.

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P281 Applying The Re-Aim Framework To Evaluate Dissemination And Implementation Of Clinical Practice Guideline For Sexually Transmitted Infections In Korea

BMJ Quality & Safety ◽

10.1136/bmjqs-2013-002293.237 ◽

2013 ◽

Vol 22 (Suppl 1) ◽

pp. A78.3-A79

Author(s):

H Jo ◽

S Chang ◽

Y Lee ◽

E Shin ◽

M Oh ◽

...

Keyword(s):

Clinical Practice ◽

Sexually Transmitted Infections ◽

Clinical Practice Guideline ◽

Practice Guideline ◽

Dissemination And Implementation ◽

Sexually Transmitted

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Clinical Guidelines 2.0: Translation of Tables 2 and 3 and Apendix 1 of Schünemann HJ et al. CMAJ. 2014; 186:E123-42.

Acta Médica Portuguesa ◽

10.20344/amp.6602 ◽

2015 ◽

Vol 28 (3) ◽

pp. 395

Author(s):

Guilherme Ferreira dos Santos ◽

Pedro Correia Azevedo ◽

António Vaz-Carneiro

Keyword(s):

Clinical Practice ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Clinical Care ◽

Canadian Medical Association Journal ◽

Dissemination And Implementation ◽

Quality Literature ◽

Intrinsic Quality ◽

The University ◽

Based Medicine

<p>Clinical Practice Guidelines are instruments to support decision to improve the quality of clinical care. An expert group from McMaster University (Canada) has developed - from high-quality literature sources – a guidance on the practical steps for their development, dissemination, implementation and evaluation. This is the 1st time anyone seeks to bring together in one document all information regarding the Clinical Practice Guidelines. Due to the interest of this paper, the Centre for Evidence Based Medicine at the University of Lisbon School of Medicine contacted the authors of the article and the journal where it was published (the Canadian Medical Association Journal) in order to translate the most relevant parts of the article (including the practice tables), which was agreed. This guide should be useful to those who, being interested in the development, dissemination and implementation of Clinical Practice Guidelines, want to ensure their intrinsic quality based on relevant and updated evidence.</p>

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Dissemination and Implementation of the Royal Australian and New Zealand College of Psychiatrists’ Clinical Practice Guidelines

Australasian Psychiatry ◽

10.1080/10398560802294597 ◽

2008 ◽

Vol 16 (5) ◽

pp. 336-339 ◽

Cited By ~ 1

Author(s):

David Codyre ◽

Andrew Wilson ◽

Juliette Begg ◽

David Barton

Keyword(s):

Clinical Practice ◽

New Zealand ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Evidence Based Practice ◽

Positive Impact ◽

System Level ◽

Dissemination And Implementation ◽

Evidence Based ◽

Zealand College

Objective: The aim of this paper is to summarize information about the dissemination and implementation of the Royal Australian and New Zealand College of Psychiatrists’ clinical practice guidelines (CPGs) since their completion in 2003, and assess the effectiveness of these activities. Method: The dissemination and implementation activities undertaken from 2003 to the present are described. Data regarding the dissemination of the clinician and consumer-carer versions of the CPGs are presented. The results of a series of implementation pilots are summarized. Results: Available data suggest the CPGs have been widely disseminated through both the clinician and consumer-carer communities in Australia and New Zealand, and that the consumer-carer versions in particular continue to be in high demand. Evaluation of CPG implementation pilots, using tools that assist in bringing summary evidence into clinical practice, have suggested that such tools are acceptable, are a useful aid to implementing evidence-based practice, and have a positive impact on practice. Common barriers to implementing the evidence are highlighted. Conclusions: Summary consumer-carer versions of CPGs seem to be acceptable and useful to both consumer-carers and non-government mental health providers. Locally led implementation of CPGs using tools that summarize evidence and support its use in everyday practice has a positive impact, but also highlights system-level barriers to implementing evidence-based practice.

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Appraising Otolaryngology–Head and Neck Surgery Clinical Practice Guidelines for Effective Dissemination and Implementation Design

Otolaryngology ◽

10.1177/0194599820910126 ◽

2020 ◽

Vol 163 (2) ◽

pp. 209-215 ◽

Cited By ~ 1

Author(s):

John P. Flynn ◽

Jennifer A. Villwock ◽

Alexander G. Chiu ◽

Kevin J. Sykes

Keyword(s):

Clinical Practice ◽

Head And Neck ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Neck Surgery ◽

Head And Neck Surgery ◽

Applicability Domain ◽

Dissemination And Implementation ◽

Agree Ii ◽

Agree Ii Instrument

Objectives Dissemination and implementation (D&I) science analyzes interventional strategies that aid in spreading scientific knowledge, adopting evidence into practice, and identifying barriers to maximize successful integration of science into practice. This study set out to critically appraise the published D&I strategies of the American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNSF) Clinical Practice Guidelines (CPGs) and to introduce the theories of D&I science. Methods The 15 AAO-HNSF CPGs underwent appraisal by 2 independent reviewers using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument. CPGs were rated over 23 key items in 6 domains. Each item was rated on a 7-point scale from 1 ( strongly disagree) to 7 ( strongly agree). CPGs were rated and quality assessments were performed. Intrarater reliability was assessed. Results The overall mean score of the CPGs was 85.2% (95% confidence interval, 83.4%-86.9%). Individual CPG mean scores ranged from 80.4% to 90.9%. Mean interrater reliability was strong. All domains of the AGREE II instrument, except the Applicability domain, scored a mean of 90.7% or better. D&I strategies within the CPGs, as calculated by the Applicability domain score, ranged from 22.9% to 77.1%. Discussion There is a paucity of published D&I strategies within the AAO-HNSF CPGs. Nesting a D&I framework, such as the Quality Improvement Framework, within CPGs would allow for identification of barriers to CPG adoption and evaluation of CPG-directed interventions. Implications for Practice A D&I framework within the AAO-HNSF CPGs would allow for objective measurement of the overall impact of CPGs on otolaryngology practices.

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Implementation of Clinical Practice Guidelines for Psychosocial Cancer Care

Psycho-Oncology ◽

10.1093/med/9780190097653.003.0101 ◽

2021 ◽

pp. 806-812

Author(s):

Jane Turner ◽

Nicole Rankin

Keyword(s):

Clinical Practice ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Clinical Care ◽

Psychosocial Care ◽

Systems Design ◽

Cost Benefit ◽

Practice Change ◽

Dissemination And Implementation ◽

Evidence Based

Psychosocial clinical practice guidelines (CPGs) provide evidence-based recommendations regarding clinical care in oncology, ranging from screening for distress to identification and treatment of disorders such as depression and anxiety. This chapter describes the evolution of CPGs, frameworks for evaluation of quality, and strategies for dissemination and implementation. It also describes the challenges in implementation of CPGs including the quality of supporting psychosocial research, which is dominated by descriptive studies rather than interventions; insufficient cost-benefit research to leverage practice change; and lack of research to guide recommendations in low- and middle-income countries. Strategies to increase implementation include alignment of research with implementation science, embedding psychosocial care in national cancer plans, and focus on systems design and clinician engagement. The role of patients and caregivers as advocates for access to evidence-based psychosocial care is also discussed.

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American Society of Clinical Oncology Clinical Practice Guidelines: Opportunities and Challenges

Journal of Clinical Oncology ◽

10.1200/jco.2008.17.7139 ◽

2008 ◽

Vol 26 (24) ◽

pp. 4022-4026 ◽

Cited By ~ 39

Author(s):

Mark R. Somerfield ◽

Kaitlin Einhaus ◽

Karen L. Hagerty ◽

Melissa C. Brouwers ◽

Jerome Seidenfeld ◽

...

Keyword(s):

Clinical Practice ◽

Clinical Oncology ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Clinical Decision Making ◽

Clinical Decision ◽

Dissemination And Implementation ◽

Clinical Tools ◽

American Society ◽

The Impact

The American Society of Clinical Oncology (ASCO) published its first clinical practice guideline, which focused on the use of hematopoietic colony-stimulating factors, in 1994. Since then, ASCO has published 24 additional guidelines or technology assessments on a range of topics and is developing 11 additional guidelines. Guidelines are among ASCO's most valued products, according to membership surveys and data from the JCO.org Web site. However, the same data from ASCO members have highlighted a number of limitations to the guideline program. These relate to the timelines of guideline updates, difficulties locating guidelines and related products, and challenges to implementing ASCO guidelines in everyday clinical practice. This article outlines the concrete steps that the ASCO Health Services Committee (HSC) is taking to address these limitations, including the institution of a more aggressive guideline updating schedule, a transition from narrative to systematic literature reviews to support the practice recommendations, a new Board of Directors–approved policy to permit endorsement of other groups’ guidelines, and a robust Clinical Tools and Resources program that offers a range of guideline dissemination and implementation aids. Additional work is underway to establish stronger and deeper collaborations with practicing oncologists to expand their role in the review, field testing, and implementation of guideline clinical tools and resources. Finally, the HSC is discussing evaluation of the guidelines program to maximize the impact of ASCO clinical practice guidelines on clinical decision making and, ultimately, the quality of cancer care.

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