The Outcomes, Barriers, and Facilitators of Implementing Clinical Prac-tice Guidelines in Iran: A Comprehensive Review

Maliheh  Ghobadi; Anahita  Behzadi; Asma  Sabermahani

doi:10.18502/ijph.v53i2.14917

Maliheh Ghobadi Department of Health Management, Policy, and Economics, Faculty of Management and Medical Information Sciences, Ker-man University of Medical Sciences, Kerman, Iran
Anahita Behzadi Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
Asma Sabermahani Health Foresight and Innovation Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sci-ences, Kerman, Iran

DOI: https://doi.org/10.18502/ijph.v53i2.14917

Keywords: Clinical practice guideline; Barrier; Facilitator; Evidence-based medicine

Abstract

Background: Clinical practice guideline (CPGs) are highly valuable in enhancing healthcare efficiency as they lead to the selection of the best medical methods and reduction of their costs. Nevertheless, implementing CPGs in practice can be quite challenging, as they require alterations at individual, organizational, and health system levels. Therefore, we aimed to identify the outcomes, barriers, and facilitators associated with CPG implementation.

Methods: We conducted an extensive search using Web of Science, PubMed, Scopus, Embase, and various non-English databases to gather quantitative, qualitative, and review studies on the implementation of CPGs from Jan 1, 1990, to Dec 26, 2022. Our analysis focused on the outcomes, barriers, and facilitators of CPG implementation, which categorized into four groups: policy-making, health system and hospitals, professional experts, and clinical guidelines.

Results: After conducting a thorough review of 37 studies, the most significant outcomes were found to be reduced costs and enhanced quality of care. However, certain challenges, such as inadequate support, insufficient education, high work pressure, tight schedules, and a lack of unified and clear guidelines, hindered these improvements. To overcome these barriers, it is essential to prioritize effective leadership, improve work conditions, allocate necessary resources, create a structured framework for the guidelines, and simplify their content to fit the clinical circumstances.

Conclusion: It is crucial to identify the outcomes and barriers associated with implementing CPGs to enhance professional performance, elevate the quality of care, and foster patient satisfaction. Developing effective strategies hinges on this awareness.