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Biomédica
Print version ISSN 0120-4157
Abstract
GARZON-ORJUELA, Nathaly; ESLAVA-SCHMALBACH, Javier and OSPINA, Nathalie. Effectiveness of knowledge translation and knowledge appropriation of clinical practice guidelines for patients and communities, a systematic review. Biomédica [online]. 2018, vol.38, n.2, pp.253-266. ISSN 0120-4157. https://doi.org/10.7705/biomedica.v38i0.3991.
Introduction:
Knowledge translation and knowledge appropriation social interventions apply knowledge to improve health services and outcomes. These interventions can be implemented routinely to improve patient adherence to clinical practice guidelines.
Objective:
To assess the effectiveness of knowledge translationinterventions to improve patient and community adherence to clinical practice guidelines.
Materials and methods:
We performed a systematic review of these interventions compared with classical interventions for patients and/or communities. We searched the following electronic databases up to April 2017: Medline (Ovid), Embase, Scopus, Central (Ovid), Web of Science, LILACS, Academic Search, and Scielo. Two independent raters qualified the relevance, risk of bias, and quality of included studies.
Results:
Eight studies were included. Patientadherencetorecommendationswasobserved in twostudies. Therewashighheterogeneityduetothevariability of thepopulation, types of guidelines, and types of measurementtools. Therisk of biaswashigh: a 60% risk of performance bias, 50% risk of attrition bias, 25% risk of selection and reporting bias, and 15% risk of detection bias. The quality of evidence was moderate for the outcomes of adherence and mortality. The interventions that used a combination of strategies, such as with the group of health professionals, could improve some clinical outcomes in the patients (Averagedeviation: -3.00; 95% IC: -6.08-0.08).
Conclusions:
Knowledge translation interventions might have a slight positive effect on patient adherence and some short-term clinical outcomes, particularly within mixed interventions (patients and health professionals). However, future studies with less heterogeneity are necessary to confirm these results.
Keywords : Practice guidelines as topic; transfer; knowledge; patients; community participation.