Strategy type | Study reference | Systematic Review Quality score | Number of included studies | Conclusions: Effectiveness, Level of change, quality of individual studies |
---|---|---|---|---|
Audit & Feedback | Bywood, P.T. et al Strategies for facilitating change in alcohol and other drugs (AOD) professional practice: a systematic review of the effectiveness of reminders and feedback (2008) | 5 | 14 | Effectiveness: Reminders and feedback are effective strategies to facilitate professional practice change and have potential in the AOD field. Level: Small and/or non-significant changes in clients' health. Quality: Some risk of bias and/or other methodological flaws was evident in most studies |
Computerised decision support | Durieux, P. et al Computerized advice on drug dosage to improve prescribing practice ( 2008) | 7 | 26 | Effectiveness: Some benefits, especially initial dosing. No effect on adverse reactions. Level: Small changes in process Quality: Although all studies used reliable outcome measures, their quality was generally low. |
 | Mollon, B. et al Features predicting the success of computerized decision support for prescribing: a systematic review of randomized controlled trials (2009) | 7 | 41 | Effectiveness: Potential exists to change health care provider behaviour; Level: Small changes in process, very few high quality studies show improvement in patient outcomes. Quality: Many studies poorly described |
Use of opinion leaders | Doumit, G. et al Local opinion leaders: effects on professional practice and health care outcomes (2007) | 7 | 12 | Effectiveness: Can successfully promote Evidence Based Practice Level: Comparable with results for audit and feedback, education dissemination, and multifaceted interventions although smaller effect size than reminders. Quality: One study was judged to be of 'low risk'. Risk of bias in three studies was considered 'moderate'. Eight studies were judged to have 'high risk' of bias. |
Multifaceted interventions | Davey, P. Interventions to improve antibiotic prescribing practices for hospital inpatients (2005) | 7 | 66 | Effectiveness: Interventions to improve antibiotic prescribing to hospital in-patients are successful, and can reduce antimicrobial resistance or hospital acquired infections. Level: Improved prescribing in at least one outcome measure for the majority of studies. Quality: The internal validity of the studies... is variable but there is a core of studies with low risk of bias or confounding' |
 | Arnold, S. R. Interventions to improve antibiotic prescribing practices in ambulatory care. (2005) | 7 | 39 | Effectiveness: The effectiveness of an intervention on antibiotic prescribing depends to a large degree on the particular prescribing behaviour and the barriers to change in the particular community. Level: Combined interventions resulted in moderate changes in prescribing behaviour and were more effective than single interventions, which resulted in small changes. Quality: Most of these studies had methodological limitations as assessed by the quality criteria of the EPOC study group |
 | Weinmann, S. et al Effects of implementation of psychiatric guidelines on provider performance and patient outcome: systematic review (2007) | 6 | 18 | Effectiveness: There is insufficient high-quality evidence to draw firm conclusions on the effects of implementation of specific psychiatric guidelines. Level: Mixed - but combined seem more effective than single interventions - the effects were moderate and temporary in most cases. Quality: Variable - overall a lack of high quality evidence hindered conclusions |
 | Simpson, H. et al Do guidelines guide pneumonia practice? A systematic review of interventions and barriers to best practice in the management of community-acquired pneumonia (2005) | 4 | 6 | Effectiveness: Combined interventions may be more successful than single interventions. Level: significant improvements in one or more measures of the process of pneumonia care. Quality: Variable |
 | Harkennes, S. & Dodd, K. Guideline implementation in allied health professions: a systematic review of the literature (2008) | 7 | 14 | Effectiveness: There is no evidence to support a set guideline implementation strategy for allied health professionals Level: Small to moderate effects detected. Results varied both within and between interventions. Quality: The methodological quality varied greatly |
 | Chaillet, N. & Dumont, A. Evidence-based strategies for educing caesarean section rates: a meta-analysis (2007) | 7 | 10 | Effectiveness: The caesarean section rate can be safely reduced by interventions that involve health workers in analyzing and modifying their practice Level: Combined more effective (especially when based on A&F) than single interventions. Identification of barriers to change is a key to success. Quality: All graded 'good' or 'fair' against EPOC guidelines |
 | Chaillet, N. et al Evidence-based strategies for implementing guidelines in obstetrics (2006) | 7 | 33 | Effectiveness: In the field of obstetric care, multifaceted strategy based on audit and feedback and facilitated by local opinion leaders is recommended to effectively change behaviours Level: Combined more effective (especially when based on A&F) than single interventions. Quality: All graded 'good' or 'fair' against EPOC guidelines |
 | Kwan, J. et al Improving the efficiency of delivery of thrombolysis for acute stroke: a systematic review (2004) | 5 | 10 | Effectiveness: Combined interventions may be more effective than single interventions Level: Small Quality: The description of study methodology and the intervention was generally satisfactory |
 | De Belvis, A. G. et al Can primary care professionals' adherence to Evidence Based Medicine tools improve quality of care in Type 2 diabetes mellitus? A systematic review (2009) | 7 | 13 | Effectiveness: The adherence to EBM instruments is likely to improve process of care, rather than patient outcomes. Level: Small Quality: Most of RCTs had methodological limitations |