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The evidence–practice gap in specialist mental healthcare: Systematic review and meta-analysis of guideline implementation studies

  • Francesca Girlanda (a1), Ines Fiedler (a2), Thomas Becker (a2), Corrado Barbui (a3) and Markus Koesters (a2)...
Abstract
Background

Clinical practice guidelines are not easily implemented, leading to a gap between research synthesis and their use in routine care.

Aims

To summarise the evidence relating to the impact of guideline implementation on provider performance and patient outcomes in mental healthcare settings, and to explore the performance of different strategies for guideline implementation.

Method

A systematic review of randomised controlled trials, controlled clinical trials and before-and-after studies comparing guideline implementation strategies v. usual care, and different guideline implementation strategies, in patients with severe mental illness.

Results

In total, 19 studies met our inclusion criteria. The studies did not show a consistent positive effect of guideline implementation on provider performance, but a more consistent small to modest positive effect on patient outcomes.

Conclusions

Guideline implementation does not seem to have an impact on provider performance, nonetheless it may influence patient outcomes positively.

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Copyright
Corresponding author
F. Girlanda, Department of Psychiatry II, Ulm University, Ludwig-Heilmeyer-Str. 2, 89312 Günzburg, Germany. Email: francesca.girlanda@uni-ulm.de
Footnotes
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Declaration of interest

None.

Footnotes
References
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  • EISSN: 1472-1465
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The evidence–practice gap in specialist mental healthcare: Systematic review and meta-analysis of guideline implementation studies

  • Francesca Girlanda (a1), Ines Fiedler (a2), Thomas Becker (a2), Corrado Barbui (a3) and Markus Koesters (a2)...
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