Strategies for dissemination and implementation of guidelines

G. Barosi

Research output: Contribution to journalArticlepeer-review


Interventions designed to effectively implement and disseminate clinical practice guidelines (CPG) fall into different categories. A systematic review of the effectiveness and costs of different guideline development, dissemination and implementation strategies was recently undertaken by the Health Technology Assessment (HTA) Programme in UK. Overall, the majority of comparisons reporting dichotomous process data observed improvement in care. However, there was considerable variation in the observed effects both within and across interventions. Evaluation studies provided evidence that adherence of physicians to CPG is a strong predictor of the stroke outcome. Cochrane Collaboration performed a systematic review including studies published up to 2004 that compared integrated clinical pathways (ICP) for stroke care with standard medical care. They found no significant difference between ICP and control groups in terms of death or discharge destination. Patients managed with a care pathway were more dependent at discharge, less likely to suffer a urinary tract infection, less likely to be readmitted and more likely to have neuroimaging. A positive effect was reported from a validation study of a multifaceted strategy for stroke care ICP implementation in Italy.

Original languageEnglish
JournalNeurological Sciences
Issue numberSUPPL. 3
Publication statusPublished - Jun 2006


  • Dissemination
  • Guideline
  • Implementation
  • Integrated clinical pathway

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)


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