Language:

What's the evidence that NICE guidance has been implemented? Results from a national evaluation using time series analysis, audit of patients' notes, and interviews

BMJ, 2004-10, Vol.329 (7473), p.999-1003 [Peer Reviewed Journal]

2004 BMJ Publishing Group Ltd. ;Copyright 2004 BMJ Publishing Group Ltd ;Copyright: 2004 (c) 2004 BMJ Publishing Group Ltd. ;Copyright © 2004, BMJ Publishing Group Ltd. 2004 ;ISSN: 0959-8138 ;ISSN: 0959-8146 ;EISSN: 1468-5833 ;EISSN: 1756-1833 ;DOI: 10.1136/bmj.329.7473.999 ;PMID: 15514342 ;CODEN: BMJOAE

Full text available

Citations Cited by

Actions
1. Add to My Research
2. Remove from My Research
3. E-mail
4. Print
5. Permalink
6. Citation
7. EasyBib
8. EndNote
9. RefWorks
10. Delicious
11. Export RIS
12. Export BibTeX

Title:
What's the evidence that NICE guidance has been implemented? Results from a national evaluation using time series analysis, audit of patients' notes, and interviews
Author: Sheldon, Trevor A ; Cullum, Nicky ; Dawson, Diane ; Lankshear, Annette ; Lowson, Karin ; Watt, Ian ; West, Peter ; Wright, Dianne ; Wright, John
Subjects: Compliance ; Defibrillators ; Female ; Guideline Adherence ; Health care ; Health care policy ; Humans ; Implantable defibrillators ; Management audits ; Medical Audit ; Medical audits ; Medical practice ; Medical treatment ; Practice Guidelines as Topic ; Primary health care ; Prosthetics ; Quality of Health Care - economics ; Quality of Health Care - standards ; State Medicine - standards ; Tax audits ; Taxoids ; Technology Assessment, Biomedical ; Teeth ; United Kingdom
Is Part Of: BMJ, 2004-10, Vol.329 (7473), p.999-1003
Description: Objectives To assess the extent and pattern of implementation of guidance issued by the National Institute for Clinical Excellence (NICE). Design Interrupted time series analysis, review of case notes, survey, and interviews. Setting Acute and primary care trusts in England and Wales. Participants All primary care prescribing, hospital pharmacies; a random sample of 20 acute trusts, 17 mental health trusts, and 21 primary care trusts; and senior clinicians and managers from five acute trusts. Main outcome measures Rates of prescribing and use of procedures and medical devices relative to evidence based guidance. Results 6308 usable patient audit forms were returned. Implementation of NICE guidance varied by trust and by topic. Prescribing of some taxanes for cancer (P < 0.002) and orlistat for obesity (P < 0.001) significantly increased in line with guidance. Prescribing of drugs for Alzheimer's disease and prophylactic extraction of wisdom teeth showed trends consistent with, but not obviously a consequence of, the guidance. Prescribing practice often did not accord with the details of the guidance. No change was apparent in the use of hearing aids, hip prostheses, implantable cardioverter defibrillators, laparoscopic hernia repair, and laparoscopic colorectal cancer surgery after NICE guidance had been issued. Conclusions Implementation of NICE guidance has been variable. Guidance seems more likely to be adopted when there is strong professional support, a stable and convincing evidence base, and no increased or unfunded costs, in organisations that have established good systems for tracking guidance implementation and where the professionals involved are not isolated. Guidance needs to be clear and reflect the clinical context.
Publisher: England: British Medical Journal Publishing Group
Language: English
Identifier: ISSN: 0959-8138
ISSN: 0959-8146
EISSN: 1468-5833
EISSN: 1756-1833
DOI: 10.1136/bmj.329.7473.999
PMID: 15514342
CODEN: BMJOAE
Source: MEDLINE
Alma/SFX Local Collection
ProQuest Central

Back to results list


INSPIRE LIBRARY - TON DUC THANG UNIVERSITY	(84-028) 37 755 057	Feedback
19 Nguyen Huu Tho St. Dist.7, HCM	thuvien@tdtu.edu.vn	Feedback

What's the evidence that NICE guidance has been implemented? Results from a national evaluation using time series analysis, audit of patients' notes, and interviews

Searching Remote Databases, Please Wait