Burgers J S
NHG, afd. Richtlijnontwikkeling en Wetenschap, Utrecht.
Ned Tijdschr Geneeskd. 2016;160:D584.
Research studies into the implementation of clinical practice guidelines often reveal only modest effects. These studies could have greater relevance if the following pitfalls were to be considered in advance. Firstly, there is a lack of awareness of the fact that physicians are overloaded with guidelines and need time for implementation, particularly when the guideline involves additional effort. Secondly, there is a lack of ownership of guidelines that were developed with involvement of many stakeholders. Thirdly, there is a lack of tailored implementation strategies focusing on specific recommendations rather than the whole guideline. Fourthly, guideline adherence is used as an outcome measure while there may be legitimate reasons to deviate from the guideline in individual cases. The future challenge for research into guideline implementation is to study how guidelines really could assist physicians in delivering personalised care.
对临床实践指南实施情况的研究往往只显示出适度的效果。如果能提前考虑以下陷阱，这些研究可能会更具相关性。首先，人们没有意识到医生被大量指南压身，实施指南需要时间，尤其是当指南需要额外的努力时。其次，许多利益相关者参与制定的指南缺乏自主性。第三，缺乏针对具体建议而非整个指南的量身定制的实施策略。第四，将遵循指南作为一项结果指标，而在个别情况下可能有合理理由偏离指南。指南实施研究未来面临的挑战是研究指南如何真正帮助医生提供个性化医疗服务。
