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BMC Primary Care
Published in: BMC Primary Care 1/2015

Open Access 01-12-2015 | Research article

Interventions to improve adherence to cardiovascular disease guidelines: a systematic review

Authors: Rebecca A. Jeffery, Matthew J. To, Gabrielle Hayduk-Costa, Adam Cameron, Cameron Taylor, Colin Van Zoost, Jill A. Hayden

Published in: BMC Primary Care | Issue 1/2015

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Abstract

Background

Successful management of cardiovascular disease (CVD) is impaired by poor adherence to clinical practice guidelines. The objective of our review was to synthesize evidence about the effectiveness of interventions that target healthcare providers to improve adherence to CVD guidelines and patient outcomes.

Methods

We searched PubMed, EMBASE, Cochrane Library, PsycINFO, Web of Science and CINAHL databases from inception to June 2014, using search terms related to adherence and clinical practice guidelines. Studies were limited to randomized controlled trials testing an intervention to improve adherence to guidelines that measured both a patient and adherence outcome. Descriptive summary tables were created from data extractions. Meta-analyses were conducted on clinically homogeneous comparisons, and sensitivity analyses and subgroup analyses were carried out where possible. GRADE summary of findings tables were created for each comparison and outcome.

Results and Discussion

We included 38 RCTs in our review. Interventions included guideline dissemination, education, audit and feedback, and academic detailing. Meta-analyses were conducted for several outcomes by intervention type. Many comparisons favoured the intervention, though only the adherence outcome for the education intervention showed statistically significant improvement compared to usual care (standardized mean difference = 0.58 [95 % confidence interval 0.35 to 0.8]).

Conclusions

Many interventions show promise to improve practitioner adherence to CVD guidelines. The quality of evidence and number of trials limited our ability to draw conclusions.
Appendix
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Metadata
Title
Interventions to improve adherence to cardiovascular disease guidelines: a systematic review
Authors
Rebecca A. Jeffery
Matthew J. To
Gabrielle Hayduk-Costa
Adam Cameron
Cameron Taylor
Colin Van Zoost
Jill A. Hayden
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2015
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-015-0341-7

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