- A Haines,
- R Jones
- Department of Primary20Health Care, University College London Medical School, Whittington Hospital, London N19 5NF
- Department of General Practice, United Medical and Dental Schools of Guy's and St Thomas's Hospitals, London SE11 6SP
- Correspondence to: Professor Haines.
- Accepted 3 December 1993
There are unacceptable delays in the implementation of many findings of research. This results in suboptimal care for patients. A number of approaches may be effective in speeding up implementation, including evidence based guidelines, the influence of opinion leaders, and computer based decision support systems. An integrated approach to speeding up this process by means of a number of mechanisms is likely to be most effective. The results of systematic reviews of the research literature should be incorporated into programmes of continuing medical education and clinical audit. Professional associations have an important role to play in ensuring that research based information is included in educational activities and clinical guidelines. Purchasers of health care could promote the uptake of research findings during contract negotiations. Improved methods of informing health care users and the public about evidence of effectiveness could also have an impact. Policy makers should take more account of the results of research when formulating recommendations. Methods of improving the implementation of research findings require further investigation and greater resources devoted to them.
The NHS research and development programme has embarked on a series of major reviews of research and development priorities in the NHS, leading to commissioned research. These priorities are being derived from assessment of research need, rather than being based on vested research interests and agendas, and stand a good chance of generating new information for implementation in practice.1 However, this sequence of events cannot be taken for granted: Machiavelli warned, “The innovator makes enemies of all those who prospered under the old order and only lukewarm support is forthcoming from those who would prosper under the new.”2 The medical literature is littered with examples of research findings that have not found timely acceptance in practice, and clinical practice is characterised by wide variations in …