Use of Implementation Strategies to Promote the Uptake of Knee Osteoarthritis Practice Guidelines and Improve Patient Outcomes: A Systematic Review.

Autor: Ramirez MM; Duke University School of Medicine, Durham, North Carolina., Fillipo R; Duke University School of Medicine, Durham, North Carolina., Allen KD; University of North Carolina at Chapel Hill, and Durham VA Health Care Center, Durham, North Carolina., Nelson AE; University of North Carolina at Chapel Hill., Skalla LA; Duke University School of Medicine, Durham, North Carolina., Drake CD; Duke University School of Medicine, Durham, North Carolina., Horn ME; Duke University School of Medicine, Durham, North Carolina.
Jazyk: angličtina
Zdroj: Arthritis care & research [Arthritis Care Res (Hoboken)] 2024 Sep; Vol. 76 (9), pp. 1246-1259. Date of Electronic Publication: 2024 May 28.
DOI: 10.1002/acr.25353
Abstrakt: Objective: Translation of knee osteoarthritis (KOA) clinical practice guidelines (CPGs) to practice remains suboptimal. The primary purpose of this systematic review was to describe the use of implementation strategies to promote KOA CPG-recommended care.
Methods: Medline (via PubMed), Embase, CINAHL, and Web of Science were searched from inception to February 23, 2023, and the search was subsequently updated and expanded on January 16, 2024. Implementation strategies were mapped per the Expert Recommendations for Implementing Change taxonomy. Risk of bias (RoB) was assessed using the Cochrane Effective Practice and Organisation of Care criteria. The review was registered prospectively (PROSPERO identifier: CRD42023402383).
Results: Nineteen studies were included in the final review. All (100% [n = 4]) studies that included the domains of "provide interactive assistance," "train and educate stakeholders" (89% [n = 16]), "engage consumers" (87% [n = 13]), and "support clinicians" (79% [n = 11]) showed a change to provider adherence. Studies that showed a change to disability included the domains of "train and educate stakeholders," "engage consumers," and "adapt and tailor to context." Studies that used the domains "train and educate stakeholders," "engage consumers," and "support clinicians" showed a change in pain and quality of life. Most studies had a low to moderate RoB.
Conclusion: Implementation strategies have the potential to impact clinician uptake of CPGs and patient-reported outcomes. The implementation context, using an active learning strategy with a patient partner, restructuring funding models, and integrating taxonomies to tailor multifaceted strategies should be prioritized. Further experimental research is recommended to determine which implementation strategies are most effective.
(© 2024 American College of Rheumatology.)
Databáze: MEDLINE
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