Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Implementation Science
Published in: Implementation Science 1/2019

Open Access 01-12-2019 | Systematic review

The effectiveness of guideline implementation strategies in the dental setting: a systematic review

Authors: Amy R. Villarosa, Della Maneze, Lucie M. Ramjan, Ravi Srinivas, Michelle Camilleri, Ajesh George

Published in: Implementation Science | Issue 1/2019

Login to get access

Abstract

Background

Guideline implementation has been an ongoing challenge in the dental practice setting. Despite this, there are no reviews summarising the existing evidence regarding effective guideline implementation strategies in this setting. In order to address this, this systematic review examines the effectiveness of guideline implementation strategies in the dental practice setting.

Methods

A systematic search was undertaken according to the PRISMA statement across nine electronic databases, targeting randomised controlled trials and quasi-experimental studies which evaluated the effectiveness of guideline implementation strategies in improving guideline adherence in the dental setting. All records were independently examined for relevance and appraised for study quality by two authors, with consensus achieved by a third author. Data were extracted from included studies using a standardised data extraction pro forma.

Results

A total of 15 records were eligible for inclusion in this review, which focused on the effects of audit and feedback, reminders, education, patient-mediated interventions, pay for performance and multifaceted interventions. Although there were some conflicting evidence, studies within each category of implementation strategy indicated a positive effect on guideline adherence.

Conclusions

This study has identified education, reminders and multifaceted interventions as effective implementation strategies for the dental practice setting. Although this is similar to research findings from other health sectors, there is some evidence to suggest patient-mediated interventions may be less effective and pay for performance may be more effective in the dental setting. These findings can inform policy makers, professional associations, colleges and organisations in the future adoption of clinical guidelines in the dental practice setting.

Trial registration

This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration ID CRD42018093023.
Appendix
Available only for authorised users
Literature
1.
Institute of Medicine (US) Committee to Advise the Public Health Service on Clinical Practice Guidelines. Clinical practice guidelines: directions for a new program. Washington (DC): National Academies Press (US); 1990.
2.
Grimshaw JM, Russell IT. Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations. Lancet. 1993;342(8883):1317–22.PubMedCrossRef
3.
Woolf SH. Practice guidelines: a new reality in medicine: iii. impact on patient care. Archives of Internal Medicine. 1993;153(23):2646–55.PubMedCrossRef
4.
Woolf SH, Grol R, Hutchinson A, Eccles M, Grimshaw J. Potential benefits, limitations, and harms of clinical guidelines. British Medical Journal (Clinical Research Ed). 1999;318(7182):527–30.PubMedCentralCrossRef
5.
Proctor EK, Landsverk J, Aarons G, Chambers D, Glisson C, Mittman B. Implementation research in mental health services: an emerging science with conceptual, methodological, and training challenges. Administration and Policy in Mental Health and Mental Health Services Research. 2009;36(1):24–34.PubMedCrossRef
6.
US Department of Health and Human Services. The road ahead: research partnerships to transform services. A report by the National Advisory Mental Health Council’s Workgroup on Services and Clinical Epidemiology Research. Bethseda, MD: National Institutes of Health, National Institute of Mental Health; 2006.
7.
Bernhardsson S, Johansson K, Nilsen P, Öberg B, Larsson MEH. Determinants of guideline use in primary care physical therapy: a cross-sectional survey of attitudes, knowledge, and behavior. Physical Therapy. 2014;94(3):343–54.PubMedCrossRef
8.
Flottorp SA, Oxman AD, Krause J, Musila NR, Wensing M, Godycki-Cwirko M, et al. A checklist for identifying determinants of practice: a systematic review and synthesis of frameworks and taxonomies of factors that prevent or enable improvements in healthcare professional practice. Implementation Science. 2013;8(1):35.PubMedCrossRefPubMedCentral
9.
Hsiao J-L, Chen R-F. Critical factors influencing physicians’ intention to use computerized clinical practice guidelines: an integrative model of activity theory and the technology acceptance model. BMC Medical Informatics and Decision Making. 2016;16(1):3.PubMedPubMedCentralCrossRef
10.
Jones JA, Reeve CA. Factors influencing the use of clinical guidelines by general practitioners working in a setting of complex multimorbidity: a case study by interviews. BMC Fam Pract. 2018;19(1):157.PubMedPubMedCentralCrossRef
11.
Sauro KM, Wiebe S, Holroyd-Leduc J, DeCoster C, Quan H, Bell M, et al. Knowledge translation of clinical practice guidelines among neurologists: a mixed-methods study. PLoS One. 2018;13(10):e0205280–e.PubMedPubMedCentralCrossRef
12.
Ouimet M, Landry R, Amara N, Belkhodja O. What factors induce health care decision-makers to use clinical guidelines? Evidence from provincial health ministries, regional health authorities and hospitals in Canada. Social Science & Medicine. 2006;62(4):964–76.CrossRef
13.
Conroy M, Shannon W. Clinical guidelines: their implementation in general practice. British journal of general practice. 1995;45(396):371–5.
14.
Cabana MD, Rand CS, Powe NR, et al. Why don’t physicians follow clinical practice guidelines? A framework for improvement. JAMA. 1999;282(15):1458–65.PubMedCrossRef
15.
Grol R, Grimshaw J. From best evidence to best practice: effective implementation of change in patients’ care. Lancet. 2003;362(9391):1225–30.PubMedCrossRef
16.
Grimshaw J, Thomas R, MacLennan G, Fraser C, Ramsay C, Vale L, et al. Effectiveness and efficiency of guideline dissemination and implementation strategies. 2004.CrossRef
17.
Prior M, Guerin M, Grimmer-Somers K. The effectiveness of clinical guideline implementation strategies – a synthesis of systematic review findings. Journal of Evaluation in Clinical Practice. 2008;14(5):888–97.PubMedCrossRef
18.
Grilli R, Lomas J. Evaluating the message: the relationship between compliance rate and the subject of a practice guideline. Medical care. 1994;32(3):202–13.PubMedCrossRef
19.
Cleveland JL, Foster M, Barker L, Gordon Brown G, Lenfestey N, Lux L, et al. Advancing infection control in dental care settings: factors associated with dentists’ implementation of guidelines from the Centers for Disease Control and Prevention. Journal of the American Dental Association. 2012;143(10):1127–38.PubMedCrossRef
20.
Spallek H, Song M, Polk DE, Bekhuis T, Frantsve-Hawley J, Aravamudhan K. Barriers to implementing evidence-based clinical guidelines: a survey of early adopters. Journal of Evidence-Based Dental Practice. 2010;10(4):195–206.PubMedCrossRef
21.
Polk DE, Weyant RJ, Shah NH, Fellows JL, Pihlstrom DJ, Frantsve-Hawley J. Barriers to sealant guideline implementation within a multi-site managed care dental practice. BMC Oral Health. 2018;18(1).
22.
Gordon JS, Lichtenstein E, Severson HH, Andrews JA. Tobacco cessation in dental settings: research findings and future directions. Drug and Alcohol Review. 2006;25(1):27–37.PubMedCrossRef
23.
Lalla E, Kunzel C, Burkett S, Cheng B, Lamster IB. Identification of unrecognized diabetes and pre-diabetes in a dental setting. Journal of Dental Research. 2011;90(7):855–60.PubMedCrossRef
24.
Tseng R, Vann WF, Perrin EM. Addressing childhood overweight and obesity in the dental office: rationale and practical guidelines. Pediatric Dentistry. 2010;32(5):417–23.PubMedPubMedCentral
25.
26.
Moher D, Liberati A, Tetzlaff J, Altman DG, The PG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLOS Medicine. 2009;6(7):e1000097.PubMedPubMedCentralCrossRef
27.
Kong AC, Ramjan L, Sousa MS, Gwynne K, Goulding J, Jones N, et al. The oral health of Indigenous pregnant women: a mixed-methods systematic review. Women and Birth. 2019.
28.
Ramjan L, Cotton A, Algoso M, Peters K. Barriers to breast and cervical cancer screening for women with physical disability: a review. Women Health. 2016;56(2):141–56.PubMedCrossRef
29.
George A, Johnson M, Blinkhorn A, Ellis S, Bhole S, Ajwani S. Promoting oral health during pregnancy: current evidence and implications for Australian midwives. J Clin Nurs. 2010;19(23–24):3324–33.PubMedCrossRef
30.
Villarosa AR, George D, Ramjan LM, Srinivas R, George A. The role of dental practitioners in addressing overweight and obesity among children: a scoping review of current interventions and strategies. Obes Res Clin Pract. 2018;12(5):405–15.PubMedCrossRef
31.
McGowan J, Sampson M, Lefebvre C. An evidence based checklist for the peer review of electronic search strategies (PRESS EBC). Evidence Based Library and Information Practice. 2010;5:1.CrossRef
32.
33.
34.
35.
36.
37.
38.
39.
Elouafkaoui P, Young L, Newlands R, Duncan EM, Elders A, Clarkson JE, et al. An audit and feedback intervention for reducing antibiotic prescribing in general dental practice: the RAPiD cluster randomised controlled trial. Plos Medicine. 2016;13(8):e1002115–e.PubMedPubMedCentralCrossRef
40.
Zahabiyoun S, Sahabi M, Kharazi MJ. Improving knowledge of general dental practitioners on antibiotic prescribing by raising awareness of the faculty of general dental practice (UK) guidelines. Journal of Dentistry (Tehran, Iran). 2015;12(3):171–6.
41.
Simons D, Williams D. Can audit improve patient care and treatment outcomes in endodontics? British Dental Journal. 2013;214(9).PubMedCrossRef
42.
Bahrami M, Deery C, Clarkson JE, Pitts NB, Johnston M, Ricketts I, et al. Effectiveness of strategies to disseminate and implement clinical guidelines for the management of impacted and unerupted third molars in primary dental care, a cluster randomised controlled trial. British Dental Journal. 2004;197(11):691–6.PubMedCrossRef
43.
Montini T, Schenkel AB, Shelley DR. Feasibility of a computerized clinical decision support system for treating tobacco use in dental clinics. Journal of Dental Education. 2013;77(4):458–62.PubMed
44.
Rindal DB, Rush WA, Schleyer TKL, Kirshner M, Boyle RG, Thoele MJ, et al. Computer-assisted guidance for dental office tobacco-cessation counseling: a randomized controlled trial. American Journal of Preventive Medicine. 2013;44(3):260–4.PubMedPubMedCentralCrossRef
45.
Fricton J, Rindal DB, Rush W, Flottemesch T, Vazquez G, Thoele MJ, et al. The effect of electronic health records on the use of clinical care guidelines for patients with medically complex conditions. Journal of the American Dental Association. 2011;142(10):1133–42.PubMedCrossRef
46.
Walsh MM, Belek M, Prakash P, Grimes B, Heckman B, Kaufman N, et al. The effect of training on the use of tobacco-use cessation guidelines in dental settings. Journal of the American Dental Association. 2012;143(6):602–13.PubMedCrossRef
47.
Amemori M, Virtanen J, Korhonen T, Kinnunen TH, Murtomaa H. Impact of educational intervention on implementation of tobacco counselling among oral health professionals: a cluster-randomized community trial. Community Dentistry and Oral Epidemiology. 2013;41(2):120–9.PubMedCrossRef
48.
Chopra R, Merali R, Paolinelis G, Kwok J. An audit of antimicrobial prescribing in an acute dental care department. Primary dental journal. 2014;3(4):24–9.PubMedCrossRef
49.
Rosseel JP, Jacobs JE, Hilberink SR, Segaar D, Akkermans R, Maassen IM, et al. Patient-reported feedback promotes delivery of smoking cessation advice by dental professionals. International Journal of Health Promotion and Education. 2012;50(3):101–10.CrossRef
50.
Gnich W, Sherriff A, Bonetti D, Conway DI, Macpherson LMD. The effect of introducing a financial incentive to promote application of fluoride varnish in dental practice in Scotland: a natural experiment. Implementation science: IS. 2018;13(1).
51.
Shelley D, Anno J, Tseng TY, Calip G, Wedeles J, Lloyd M, et al. Implementing tobacco use treatment guidelines in public health dental clinics in New York City. Journal of Dental Education. 2011;75(4):527–33.PubMed
52.
Afuakwah C, Welbury R. Why do you need to use a caries risk assessment protocol to provide an effective caries preventive regime? Primary Dental Journal. 2015;4(4):56–59, 61–6.PubMedCrossRef
53.
Isaacson TT. Improving implementation of oral cancer screening recommendations [Ph.D.]. Ann Arbor: University of Colorado at Denver; 2006.
54.
Goldsmith MR, Bankhead CR, Austoker J. Synthesising quantitative and qualitative research in evidence-based patient information. Journal of epidemiology and community health. 2007;61(3):262–70.PubMedPubMedCentralCrossRef
55.
56.
57.
Powell BJ, Waltz TJ, Chinman MJ, Damschroder LJ, Smith JL, Matthieu MM, et al. A refined compilation of implementation strategies: results from the Expert Recommendations for Implementing Change (ERIC) project. Implementation Science. 2015;10(1):21.PubMedCrossRefPubMedCentral
58.
Ivers N, Jamtvedt G, Flottorp S, Young JM, Odgaard-Jensen J, French SD, et al. Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev. 2012;6.
59.
Colquhoun HL, Carroll K, Eva KW, Grimshaw JM, Ivers N, Michie S, et al. Advancing the literature on designing audit and feedback interventions: identifying theory-informed hypotheses. Implementation Science. 2017;12(1):117.PubMedCrossRefPubMedCentral
60.
Ebben RHA, Siqeca F, Madsen UR, Vloet LCM, van Achterberg T. Effectiveness of implementation strategies for the improvement of guideline and protocol adherence in emergency care: a systematic review. BMJ Open. 2018;8(11):e017572.PubMedPubMedCentralCrossRef
61.
Watkins K, Wood H, Schneider CR, Clifford R. Effectiveness of implementation strategies for clinical guidelines to community pharmacy: a systematic review. Implementation science : IS. 2015;10(1):151.PubMedCrossRefPubMedCentral
62.
Ammenwerth E, Schnell-Inderst P, Machan C, Siebert U. The effect of electronic prescribing on medication errors and adverse drug events: a systematic review. J Am Med Inform Assoc. 2008;15(5):585–600.PubMedPubMedCentralCrossRef
63.
Cheung A, Weir M, Mayhew A, Kozloff N, Brown K, Grimshaw J. Overview of systematic reviews of the effectiveness of reminders in improving healthcare professional behavior. Systematic Reviews. 2012;1(1):36.PubMedPubMedCentralCrossRef
64.
Durieux P, Trinquart L, Colombet I, Nies J, Walton R, Rajeswaran A, et al. Computerized advice on drug dosage to improve prescribing practice. Cochrane Database Syst Rev. 2008;3:Cd002894.
65.
Fonhus MS, Dalsbo TK, Johansen M, Fretheim A, Skirbekk H, Flottorp SA. Patient-mediated interventions to improve professional practice. Cochrane Database Syst Rev. 2018;9:Cd012472.PubMed
66.
Francke AL, Smit MC, de Veer AJ, Mistiaen P. Factors influencing the implementation of clinical guidelines for health care professionals: a systematic meta-review. BMC Medical Informatics and Decision Making. 2008;8(1):38.PubMedPubMedCentralCrossRef
Metadata
Title
The effectiveness of guideline implementation strategies in the dental setting: a systematic review
Authors
Amy R. Villarosa
Della Maneze
Lucie M. Ramjan
Ravi Srinivas
Michelle Camilleri
Ajesh George
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Implementation Science / Issue 1/2019
Electronic ISSN: 1748-5908
DOI
https://doi.org/10.1186/s13012-019-0954-7

Other articles of this Issue 1/2019

Implementation Science 1/2019 Go to the issue

Systematic review

Spread tools: a systematic review of components, uptake, and effectiveness of quality improvement toolkits

Correction

Correction to: Hospital organizational context and delivery of evidence-based stroke care: a cross-sectional study

Systematic review

Implementation effectiveness of health interventions for indigenous communities: a systematic review

Research

The effect of a clinical decision support system on prompting an intervention for risky alcohol use in a primary care smoking cessation program: a cluster randomized trial

Debate

Implementation capital: merging frameworks of implementation outcomes and social capital to support the use of evidence-based practices

Research

Implementation of change in health care in Sweden: a qualitative study of professionals’ change responses