Why the study?
Do implementation interventions improve physician adherence to guideline recommendations and clinical outcomes in heart failure?
Do implementation interventions improve physician adherence to guideline recommendations and clinical outcomes in heart failure?
While implementation interventions like multidisciplinary teams improve guideline adherence in heart failure management, these process improvements rarely translate into better clinical outcomes.
Process gains from implementation rarely improve heart failure outcomes; challenges process-surrogate reliance and leaves open direct-outcome trials.
Our study is limited by the quality and heterogeneity of the primary studies. Clinical pathways, multidisciplinary teams and multifaceted interventions appear to be most consistent in increasing guideline uptake. However, improvements in process outcomes were rarely accompanied by improvements in clinical outcomes. Our work highlights the need for improved research methodology to reliably assess the effectiveness of implementation interventions.
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Shanbhag et al. (2018) studied this question.
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