Data from: Sustainability of professionals’ adherence to clinical practice guidelines in medical care: a systematic review

Objectives: To evaluate 1) the state of the art in sustainability research and 2) the outcomes of professionals’ adherence to guideline recommendations in medical practice more than one year following the cessation of active implementation. Design Systematic review: Data sources: Searches were conducted till August 2015 in MEDLINE, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) and the Guidelines International Network (GIN) library. A snowball strategy, in which reference sections of other reviews and of included papers were searched, was used to identify additional papers. Eligibility criteria: Studies needed to be focused on sustainability and on professionals’ adherence to clinical practice guidelines in medical care. Studies had to include at least two measurements: one before (PRE) or immediately after implementation (EARLY POST) and one measurement longer than one year after active implementation (LATE POST). Results: The search retrieved 4219 items, of which fourteen studies met the inclusion criteria, involving eighteen sustainability evaluations. The mean timeframe between the end of active implementation and the sustainability evaluation was 2.6 years [min 1.5 – max 7.0]. The studies were heterogeneous with respect to their methodology. Sustainability was considered to be successful if performance in terms of professionals’ adherence was fully maintained in the late post-implementation phase. Long-term sustainability of professionals’ adherence was reported in seven out of eighteen evaluations, adherence was not sustained in six evaluations, four evaluations showed mixed sustainability results and in one evaluation it was unclear whether the professional adherence was sustained. Conclusions: Professionals’ adherence to a clinical practice guideline in medical care decreased after more than one year after implementation in about half of the cases. Moreover, this review showed that there is no uniform definition used in the studies, the studies have a high risk of bias, and the results with respect to sustainability of professionals’ adherence are mixed.