Artikel
Barriers and facilitators of adherence to clinical practice guidelines in Germany: a systematic review
Suche in Medline nach
Autoren
-
Eni Shehu
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School (Theodor Fontane), Institute for Health Services and Health Systems Research, Rüdersdorf bei Berlin, Germany; Center for Health Services Research, Brandenburg Medical School (Theodor Fontane), Rüdersdorf bei Berlin, Germany
-
Charlotte M Kugler
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School (Theodor Fontane), Institute for Health Services and Health Systems Research, Rüdersdorf bei Berlin, Germany; Center for Health Services Research, Brandenburg Medical School (Theodor Fontane), Rüdersdorf bei Berlin, Germany
-
Niklas Schäfer
- Brandenburg Medical School (Theodor Fontane), Neuruppin, Germany
-
Corinna Schaefer
- German Agency for Quality in Medicine, Berlin, Germany
-
Thomas Kötter
- Institute of Family Medicine, University Medical Centre Schleswig-Holstein, Lübeck, Germany
-
Markus Follmann
- German Guideline Program in Oncology, German Cancer Society, Berlin, Germany
-
Dawid Pieper
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School (Theodor Fontane), Institute for Health Services and Health Systems Research, Rüdersdorf bei Berlin, Germany; Center for Health Services Research, Brandenburg Medical School (Theodor Fontane), Rüdersdorf bei Berlin, Germany
| Veröffentlicht: | 2. Oktober 2023 |
|---|
Gliederung
Text
Background and state of research: Clinical practice guidelines (CPGs) are instruments that aim to assist practitioners’ and patients’ decisions in clinical practice. The successful implementation and adherence of CPGs are however influenced by different factors such as personal beliefs, cultural, economic, ethnical, organisational and local context factors.
Research question and objectives: The aim of this systematic review is to investigate the barriers and facilitators regarding the adherence of CPGs in Germany.
Method: The study protocol is published in the Open Science Framework. We searched for primary studies (qualitative, quantitative and mixed-methods) that report on barriers or facilitators to CPGs adherence in Germany. We searched PubMed and Embase in November 2022. Two reviewers independently screened the articles, extracted the data, and assessed the quality of the studies (Mixed Methods Appraisal Tool). Data collected on barriers and facilitators of CPG adherence was mapped and analysed based on the domains of the Theoretical Domains Framework (TDF).
Results: The included studies (n=24) mainly examined national guidelines. The TDF domains of environmental context and resources (e.g. employer support for guideline use), beliefs about consequences (e.g. contradiction with their experience), and knowledge (e.g. no knowledge about the guideline) were among the most frequently reported barriers by health care professionals. As facilitators, the most frequently cited categories were environmental context and resources (e.g., electronic tools that facilitate decision making), knowledge (e.g. physician education), and reinforcement (e.g. financial support).
Discussion: The use of the TDF framework allowed us to map the influencing factors of CPGs adherence. Multidimensional factors were identified that contributed to clinical guideline adherence. Factors pertaining to environmental context and resources were the most reported factors.
Implication for care: In this systematic review, we aimed to investigate the barriers and facilitators of adherence to CPGs in Germany. The results should lead to a better understanding of the topic and at the same time form a basis for developing strategies to improve guideline adherence and implementation in Germany.
