Education And Debate Getting research findings into practice

Closing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings

BMJ 1998; 317 doi: http://dx.doi.org/10.1136/bmj.317.7156.465 (Published 15 August 1998) Cite this as: BMJ 1998;317:465
  1. Lisa A Bero, associate professora,
  2. Roberto Grilli, headb,
  3. Jeremy M Grimshaw, programme director (j.m.grimshaw@abdn.ac.uk)c,
  4. Emma Harvey, research fellowd,
  5. Andrew D Oxman, directore,
  6. Mary Ann Thomson, senior research fellowc
  1. Institute for Health Policy Studies, University of California at San Francisco, 1388 Sutter Street, 11th floor, San Francisco, CA 94109, USA
  2. Unit of Clinical Policy Analysis, Laboratory of Clinical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri, Via Eritrea 62, 20157 Milan, Italy
  3. Health Services Research Unit, Department of Public Health, Aberdeen AB25 2ZD
  4. Department of Health Sciences and Clinical Evaluation, University of York, York YO1 5DD
  5. Health Services Research Unit, National Institute of Public Health, PO Box 4404 Torshov, N-0462 Oslo, Norway
  1. cCorrespondence to: Dr Grimshaw

    This is the seventh in a series of eight articles analysing the gap between research and practice

    Series editors: Andrew Haines and Anna Donald

    Despite the considerable amount of money spent on clinical research relatively little attention has been paid to ensuring that the findings of research are implemented in routine clinical practice.1 There are many different types of intervention that can be used to promote behavioural change among healthcare professionals and the implementation of research findings. Disentangling the effects of intervention from the influence of contextual factors is difficult when interpreting the results of individual trials of behavioural change.2 Nevertheless, systematic reviews of rigorous studies provide the best evidence of the effectiveness of different strategies for promoting behavioural change. 3 4 In this paper we examine systematic reviews of different strategies for the dissemination and implementation of research findings to identify evidence of the effectiveness of different strategies and to assess the quality of the systematic reviews.

    Summary points

    Systematic reviews of rigorous studies provide the best evidence on the effectiveness of different strategies to promote the implementation of research findings

    Passive dissemination of information is generally ineffective

    It seems necessary to use specific strategies to encourage implementation of research based recommendations and to ensure changes in practice

    Further research on the relative effectiveness and efficiency of different strategies is required

    Identification and inclusion of systematicreviews

    We searched Medline records dating from 1966 to June 1995 using a strategy developed in collaboration with the NHS Centre for Reviews and Dissemination. The search identified 1139 references. No reviews from the Cochrane Effective Practice and Organisation of Care Review Group4 had been published during this time. In addition, we searched the Database of Abstracts of Research Effectiveness (DARE) (http://www.york.ac.uk/inst/crd) but did not identify any other review meeting the inclusion criteria.

    We searched for any review …

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