Tools developed and disseminated by guideline producers to promote the uptake of their guidelines.

Background Clinical practice guidelines (CPGs) are evidence-based recommendations for healthcare professionals about the care of patients with specific conditions. The uptake of CPGs by healthcare professionals is inconsistent, despite their potential to improve the quality of health care and patient outcomes. Some guideline producers have addressed this problem by developing tools to encourage the adoption of new guidelines.This review focuses on the effectiveness of tools developed and distributed by recognised guideline producers to improve the uptake of their CPGs. Characteristics of included studies Researchers from Cochrane searched the literature up to February 2016 and identified four randomised studies evaluating the effects of tools developed by recognised guideline producers to implement their guidelines. These were developed by guideline producers in France, the Netherlands and in the USA and Canada. In all four studies the interventions targeted the healthcare professional. None of the tools specifically targeted the organisation of care or the patient. The clinical conditions, and the healthcare professionals’ behaviour targeted by the CPG, varied across studies, as did the tools used to improve guideline implementation. Key results Two of the four included studies reported on how well healthcare professionals stick to guideline recommendations when providing care to their patients, depending on whether they received a CPG with a tool aimed at improving the use of the CPG, or if they received the CPG only. The results of this review show that healthcare professionals who received a guideline tool together with the CPG on the management of non-specific low back pain or ordering thyroid-function tests probably stick more closely to the recommendations, compared with those who received the CPG only. A guideline tool aimed at improving the use of a guideline, may lead to little or no difference in cost to the health service. Certainty of the included evidence The included evidence was from randomised controlled trials, which is considered the highest level of evidence. However, due to high risk of bias in the included studies our confidence in the effect on observing guideline recommendations was moderate. Our confidence in the evidence for cost effectiveness was low, since only a single study provided evidence for this comparison