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Guideline dissemination - Which clinical guideline dissemination strategies improve professional practice?

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A clinical guideline is a systematically developed statement intended to assist practitioners make appropriate decisions about health care for specific clinical circumstances. Potential dissemination strategies for clinical guidelines include use of:
- Educational materials, i.e. distribution of published or printed recommendations for clinical care, including clinical practice guidelines and audiovisual materials;
- Educational meetings, i.e. participation by healthcare providers in conferences, lectures, workshops or traineeships;
- Audit and feedback, i.e. any summary of clinical performance of health care over a specified period;
- Patient-mediated interventions, i.e. new clinical information (not previously available) collected directly from patients and given to the provider;
- Reminders, i.e. patient-or encounter-specific information, provided verbally, on paper or on a computer screen, which is intended to prompt a health professional to recall information;
- Educational outreach, i.e. use of trained persons who meet with providers in their practice settings to give information with the intent of changing providers practice.

Key messages

- None of the studies included in this summary were conducted in a low-income country, only two were conducted in middle-income countries, and the rest were from highincome countries.
- The studies yield moderate quality evidence that use of the dissemination strategies (either individually or in combination) leads to improvements in guideline implementation and patient outcomes.
- Resources available for maintaining and improving quality of care need to be considered when assessing whether the intervention effects are likely to be transferable to other settings in high- and middle-income countries. Rigorous studies from low-income countries are needed to fully assess applicability in all healthcare settings.


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