How to implement clinical practice guidelines in Iran

Abstract EN

Background : Evidence-based medicine will come to the result by evidence-based implementation.

Clinical Practice Guidelines (CPG) as one of the evidence-based knowledge products requires appropriate interventions after being produced in order to be applied.

This qualitative study was done aiming at identifying the strategies for application of CPGs produced in Iran.

Objectives : This study, including oral consent of participants, has been approved by the Institutional Review Board of Tehran University of Medical Sciences, which follows the Helsinki Declaration.

The oral consent was performed since the study did not have any procedure and or question that could have harmed study subjects.

Materials and Methods : The purposive snowball sampling was done and it continued until reaching to the theoretical saturation.

Individual interviews in the form of in-depth semi-structured ones and Focus Group Discussion (FGD) were performed aiming at triangulation.

The thematic framework approach was used for analysis.

Results : Twelve interviews were conducted with three health system policy makers and decision makers, four experienced in the production or adaptation of clinical practices and five experts in evidence-based medicine development and education.

In addition, 11 policy makers, managers and decision makers of the health system took part in FGD.

The proposed interventions were classified in the following themes: Health professionals-oriented, Financial, Organizational, Regulatory and Multifaceted interventions.

Conclusions : Along with adaptation and development process of CPGs, their utilization should also be planned; otherwise spent time and money would be in vain.

Certainly, imposing above-mentioned interventions with the ultimate goal of sustainable behavior change in health system service providers is beyond the capacity of specific groups or few academic centers.

It requires the participation of all practitioners under the monitoring and support of the Ministry of Health and Medical Education.

Deployment of the family physician plan and referral system is an opportunity that must be considered as a trophy.