Educational Interventions for Implementation of Arthritis Clinical Practice Guidelines in Primary Care: Effects on Health Professional Behavior

2010 ◽  
Vol 37 (8) ◽  
pp. 1562-1569 ◽  
Author(s):  
SYDNEY C. LINEKER ◽  
JANICE A. HUSTED
Keyword(s):  
Primary Care ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Care Delivery ◽  
Statistical Significance ◽  
Educational Interventions ◽  
Educational Programs ◽  
Educational Outreach ◽  
System Level

Objective.The dissemination and adoption of clinical practice guidelines (CPG) has been suggested as one method for improving arthritis care delivery. This article provides a review and synthesis of studies evaluating the influence of educational programs designed to implement CPG for osteoarthritis (OA) and rheumatoid arthritis (RA) in primary care.Methods.A systematic literature search was conducted to identify relevant educational interventions that reported behavioral outcomes that ensured actual knowledge utilization in primary care. A standardized approach was used to assess the quality of the individual studies and a modified version of the Philadelphia Panel methodology allowed for grading of studies based on strength of design, clinical relevance, and statistical significance.Results.The search identified 485 articles; 7 studies were selected for review. In OA, peer facilitated workshops with nurse case-management support for patients decreased the number of referrals to orthopedics by 23%, and educational outreach by trained physicians improved prescribing of analgesics. Interprofessional peer facilitated workshops were successful in increasing referrals to rehabilitation services for people with OA and RA.Conclusion.There was sparse literature on educational programs for the implementation of arthritis CPG in the primary care environment. Future studies are needed to evaluate which specific organizational, provider, patient, and system level factors influence the uptake of arthritis CPG in primary care.

Effectiveness of Implementation Strategies to Improve Adherence of Physical Therapist Treatment Choices to Clinical Practice Guidelines for Musculoskeletal Conditions: Systematic Review

2020 ◽  
Vol 100 (9) ◽  
pp. 1516-1541
Author(s):  
Joshua R Zadro ◽  
Mary O’Keeffe ◽  
Jodie L Allison ◽  
Kirsty A Lembke ◽  
Joanna L Forbes ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Physical Therapists ◽  
Care Delivery ◽  
Peer Assessment ◽  
Implementation Strategies ◽  
Educational Outreach ◽  
Treatment Choices ◽  
Musculoskeletal Conditions

Abstract Objective The objective of this study was to evaluate the effectiveness of implementation strategies aimed at improving the adherence of physical therapists’ treatment choices to clinical practice guidelines for a range of musculoskeletal conditions. Methods For this review, searches were performed in several databases combining terms synonymous with “practice patterns” and “physical therapy” until August 2019. The review included randomized controlled trials that investigated any intervention to improve the adherence of physical therapists’ treatment choices to clinical practice guidelines or research evidence. Treatment choices assessed by surveys, audits of clinical notes, and treatment recording forms were the primary measures of adherence. Self-reported guideline adherence was the secondary measure. Three reviewers independently assessed risk of bias. Because of heterogeneity across studies, only a narrative synthesis of the results was performed. Results Nine studies were included. Four demonstrated a positive effect on at least 1 measure of treatment choices for low back pain and acute whiplash. One involved a comparison with no intervention, and 3 involved a comparison with another active intervention. The interventions that demonstrated a positive effect included dissemination of clinical practice guidelines, with additional elements including interactive educational meetings (3 studies), tailored interventions and monitoring of the performance of health care delivery (1 study), peer assessment (1 study), and local opinion leaders plus educational outreach visits (1 study). Conclusions Although this review revealed limited trials evaluating interventions to increase physical therapists’ use of evidence-based treatments for musculoskeletal conditions compared with no intervention, it highlighted some interventions that may be effective. Impact Dissemination of clinical practice guidelines, interactive educational meetings, tailored interventions and monitoring the performance of health care delivery, peer assessment, and use of local opinion leaders plus educational outreach visits should be implemented to improve physical therapists’ adherence to clinical practice guidelines for a range of musculoskeletal conditions.

scholarly journals Clinical practice guidelines and principles of care for people with dementia: a protocol for undertaking a Delphi technique to identify the recommendations relevant to primary care nurses in the delivery of person-centred dementia care

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e044843
Author(s):  
Caroline Gibson ◽  
Dianne Goeman ◽  
Mark William Yates ◽  
Dimity Pond
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Dementia Care ◽  
Care Nurse ◽  
Primary Care Nurse ◽  
People With Dementia ◽  
Primary Care Nurses

IntroductionNationally and internationally it is well recognised that dementia is poorly recognised and suboptimally managed in the primary care setting. There are multiple and complex reasons for this gap in care, including a lack of knowledge, high care demands and inadequate time for the general practitioner alone to manage dementia with its multiple physical, psychological and social dimensions. The primary care nurse potentially has a role in assisting the general practitioner in the provision of evidence-based dementia care. Although dementia-care guidelines for general practitioners exist, evidence on resources to support the primary care nurse in dementia care provision is scarce. The ‘Australian Clinical Practice Guidelines and Principles of Care for People with Dementia’ provides 109 recommendations for the diagnosis and management of dementia. This protocol describes a Delphi study to identify which of the 109 recommendations contained in these multidisciplinary guidelines are relevant to the primary care nurse in the delivery of person-centred dementia care in the general practice setting.Methods and analysisUsing a Delphi consensus online survey, an expert panel will grade each of the recommendations written in the ‘Clinical Practice Guidelines and Principles of Care for People with Dementia’ as high-to-low relevance with respect to the role of the primary care nurse in general practice. To optimise reliability of results, quality indicators will be used in the data collection and reporting of the study. Invited panel members will include Australian primary care nurses working in general practice, primary care nursing researchers and representatives of the Australian Primary Health Care Nurses Association, the peak professional body for nurses working in primary healthcare.Ethics and disseminationThis study has been approved by The University of Newcastle Human Research Ethics Committee (HREC) (H-2019-0029).Findings will be published in a peer-reviewed journal and presented at scientific conferences.

scholarly journals A review of clinical practice guidelines found that they were often based on evidence of uncertain relevance to primary care patients

2014 ◽  
Vol 67 (11) ◽  
pp. 1251-1257 ◽  
Author(s):  
Nicholas Steel ◽  
Asmaa Abdelhamid ◽  
Tim Stokes ◽  
Helen Edwards ◽  
Robert Fleetcroft ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Primary Care Patients

Empfehlungen für das Management nicht spezifischer Rückenschmerzen

2020 ◽  
Vol 24 (01) ◽  
pp. 6-7
Author(s):  
Arne Vielitz
Keyword(s):  
Primary Care ◽  
Low Back Pain ◽  
Back Pain ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Low Back

Oliveira CB, Maher CG, Pinto RZ et al. Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. Eur Spine J 2018; 27: 2791–2803. doi: 10.1007/s00586–018–5673–2. Epub 2018 Jul 3

scholarly journals A Critical Approach to Clinical Practice Guidelines

2000 ◽  
Vol 14 (6) ◽  
pp. 505-509 ◽  
Author(s):  
John K Marshall
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Patient Outcomes ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Care Delivery ◽  
Critical Approach ◽  
High Quality ◽  
Number Of Publications ◽  
Improve Patient

The rate of publication of clinical practice guidelines for the management of common medical illnesses continues to accelerate. The appropriate dissemination and uptake of high quality practice guidelines can synthesize evidence, improve patient outcomes and enhance the efficiency of health care delivery. However, the methodological rigour and relevance of the growing number of publications labelled ’clinical practice guidelines’ vary widely. Health care payers, providers and advocates must learn to appraise and interpret guideline recommendations critically. A simple and practical nine-question approach to evaluating the quality, relevance and effectiveness of clinical practice guidelines is presented.

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