ReviewAssessing the effectiveness of strategies to implement clinical guidelines for the management of chronic diseases at primary care level in EU Member States: A systematic review
Section snippets
Background
The development of clinical guidelines has increased markedly over the past two decades. Clinical guidelines seek to improve the quality of care provided by reducing harmful management and improving the cost-effectiveness of care [1]. A mapping exercise [2] identified how all EU Member States are showing interest in developing and implementing clinical guidelines. Most have an established clinical guideline programme, and a substantial proportion of them develop clinical guidelines on
Types of studies
To be considered for inclusion the study had to assess the effectiveness of a strategy to implement clinical guidelines for the management of illustrative common chronic diseases in primary care in EU Member States. These were Coronary Heart Diseases, Chronic Cardiovascular Diseases, Cerebrovascular Diseases (stroke), Hypertension, Diabetes Mellitus Type 2, Chronic Obstructive Pulmonary Disease, Asthma, Arthritis (Osteoarthritis, Rheumatoid Arthritis, Sacroiliitis, Spondylarthritis,
Search results
The search strategy yielded 2562 citations (eTable 1–eTable 5). After removing duplicates and screening, 27 records that corresponded to 21 studies were included [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32], [33], [34], [35], [36], [37]. There were six studies with two publications each [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21], [22]. The selection process is presented in Fig. 1. The
Discussion
We found only 21 studies assessing the implementation of guidelines for the management of chronic conditions in primary care in EU Member States.
Only four studies reported interventions that were fully effective (19%), in eight they were partially effective (38%), while nine found no evidence of effectiveness (43%). However the results varied across included studies. Multifaceted interventions were only slightly more effective compared to those implementing a single intervention. Due to the
Conflicts of interest
We are not aware of any relationships or support which might be perceived as conflict of interest.
Funding
This paper is the result of research that was requested by the European Commission's Directorate–General for Health & Consumer and co-funded through the EU's FP7 Cooperation Work Programme: Health (contract number 242058; contract acronym EUCBCC). The European Observatory on Health Systems and Policies is responsible for conducting this work. The European Commission is not responsible for the content of the paper. Responsibility for the facts described in the report and the views expressed
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