Skip to main content

Table 1 Characteristics and results of included systematic reviews

From: Effective implementation of research into practice: an overview of systematic reviews of the health literature

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