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

Annette Boaz1*, Juan Baeza2, Alec Fraser3 and the European Implementation Score Collaborative Group (EIS)

Author Affiliations

1 Department of Primary Care and Public Health Sciences, King's College London, 7th Floor, Capital House, 42 Weston Street, London SE1 3QD, UK

2 Department of Management, School of Social Science and Public Policy, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK

3 Department of Management, School of Social Science and Public Policy, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK

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BMC Research Notes 2011, 4:212  doi:10.1186/1756-0500-4-212

Published: 22 June 2011

Abstract

Background

The gap between research findings and clinical practice is well documented and a range of interventions has been developed to increase the implementation of research into clinical practice.

Findings

A review of systematic reviews of the effectiveness of interventions designed to increase the use of research in clinical practice. A search for relevant systematic reviews was conducted of Medline and the Cochrane Database of Reviews 1998-2009. 13 systematic reviews containing 313 primary studies were included. Four strategy types are identified: audit and feedback; computerised decision support; opinion leaders; and multifaceted interventions. Nine of the reviews reported on multifaceted interventions. This review highlights the small effects of single interventions such as audit and feedback, computerised decision support and opinion leaders. Systematic reviews of multifaceted interventions claim an improvement in effectiveness over single interventions, with effect sizes ranging from small to moderate. This review found that a number of published systematic reviews fail to state whether the recommended practice change is based on the best available research evidence.

Conclusions

This overview of systematic reviews updates the body of knowledge relating to the effectiveness of key mechanisms for improving clinical practice and service development. Multifaceted interventions are more likely to improve practice than single interventions such as audit and feedback. This review identified a small literature focusing explicitly on getting research evidence into clinical practice. It emphasizes the importance of ensuring that primary studies and systematic reviews are precise about the extent to which the reported interventions focus on changing practice based on research evidence (as opposed to other information codified in guidelines and education materials).