Characteristics and impact of interventions to support healthcare providers’ compliance with guideline recommendations for breast cancer: a systematic literature review

Implementation Science

Systematic Review

Ignacio Ricci-Cabello¹  Pablo Alonso-Coello²  Ivan Solಠ Elena Parmelli³  Zuleika Saz-Parkinson³  Gian Paolo Morgano³  Luciana Neamtiu³  Darla Carvallo-Castañeda⁴  Adrián Vásquez-Mejía⁴  David Rigau⁵  Ena Niño-de-Guzmán⁶ 

[1] Balearic Islands Health Research Institute (IdISBa), Palma, Spain;Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Palma, Spain;CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain;CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain;Iberoamerican Cochrane Centre-Department of Clinical Epidemiology and Public Health, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain;European Commission, Joint Research Centre (JRC), Ispra, Italy;Facultad de Medicina Humana, Universidad Nacional Mayor de San Marcos, Lima, Peru;Iberoamerican Cochrane Centre-Department of Clinical Epidemiology and Public Health, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain;Iberoamerican Cochrane Centre-Department of Clinical Epidemiology and Public Health, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain;Cancer Prevention and Control Programme, Catalan Institute of Oncology, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain;

关键词: Breast cancer;    Clinical guidelines;    Compliance;    Interventions;    Systematic literature review;   

DOI  :  10.1186/s13012-023-01267-2

 received in 2022-05-17, accepted in 2023-03-14,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundBreast cancer clinical practice guidelines (CPGs) offer evidence-based recommendations to improve quality of healthcare for patients. Suboptimal compliance with breast cancer guideline recommendations remains frequent, and has been associated with a decreased survival. The aim of this systematic review was to characterize and determine the impact of available interventions to support healthcare providers’ compliance with CPGs recommendations in breast cancer healthcare.MethodsWe searched for systematic reviews and primary studies in PubMed and Embase (from inception to May 2021). We included experimental and observational studies reporting on the use of interventions to support compliance with breast cancer CPGs. Eligibility assessment, data extraction and critical appraisal was conducted by one reviewer, and cross-checked by a second reviewer. Using the same approach, we synthesized the characteristics and the effects of the interventions by type of intervention (according to the EPOC taxonomy), and applied the GRADE framework to assess the certainty of evidence.ResultsWe identified 35 primary studies reporting on 24 different interventions. Most frequently described interventions consisted in computerized decision support systems (12 studies); educational interventions (seven), audit and feedback (two), and multifaceted interventions (nine). There is low quality evidence that educational interventions targeted to healthcare professionals may improve compliance with recommendations concerning breast cancer screening, diagnosis and treatment. There is moderate quality evidence that reminder systems for healthcare professionals improve compliance with recommendations concerning breast cancer screening. There is low quality evidence that multifaceted interventions may improve compliance with recommendations concerning breast cancer screening. The effectiveness of the remaining types of interventions identified have not been evaluated with appropriate study designs for such purpose. There is very limited data on the costs of implementing these interventions.ConclusionsDifferent types of interventions to support compliance with breast cancer CPGs recommendations are available, and most of them show positive effects. More robust trials are needed to strengthen the available evidence base concerning their efficacy. Gathering data on the costs of implementing the proposed interventions is needed to inform decisions about their widespread implementation.Trial registrationCRD42018092884 (PROSPERO)

【 授权许可】

CC BY   
© European Union 2023

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