Article
Evaluation of an implementation strategy to improve guideline adherence with a focus on barriers and solutions
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Authors
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E. Brouwers
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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M. Joosen
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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B. Terluin
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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J. Van der Klink
- University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
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K. Van Beurden
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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J. Van Weeghel
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| Published: | July 10, 2012 |
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Outline
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Background: Physicians’ guideline adherence is often suboptimal. For instance, adherence to the Dutch guideline ‘Management of workers with common mental health problems’ by occupation physicians (OPs) is fairly low.
Objectives: The aim of the study was to evaluate the effect of a specific implementation strategy to enhance guideline adherence by OPs.
Methods: Six groups of about 6 OPs received 8 training sessions with a heavy focus on barriers for implementation. Action research was used and accordingly the OPs discussed their own solutions and practiced them. Inspired by Cabana’s framework, sessions were specifically designed to enhance: (1) knowledge; (2) positive attitudes, and (3) overcoming external barriers for behavior change. Guideline adherence was measured by self-report and in medical files.
Results: Preliminary results show that the participating occupational physicians were highly positive about the training. They indicated that the format of the training had lead to an improvement of their own guideline adherence, especially the fact that the training was conducted in small groups, focused on barriers, and contained much discussion and repetition. Effects included improved attitudes, self-efficacy and knowledge.
Discussion: The study is part of a randomized controlled trial that also investigates if guideline use leads to quicker recovery and return-to-work of sick-listed workers. Results of this larger study are expected in 2014.
Implications: As the preliminary results were positive and the methods of the training were not guideline specific, this implementation strategy may also be useful to enhance adherence to other guidelines.
