Tailored interventions to overcome identified barriers to change: effects on professional practice and health care outcomes.

Abstract:

BACKGROUND:Strategies to implement change in health professional performance have variable impact. A potential explanation is that the barriers to implementation are different in different settings and at different times. Change may be more likely if the strategies were specifically chosen to address the identified barriers. OBJECTIVES:To assess the effectiveness of strategies tailored to address specific, identified barriers to change in professional performance. SEARCH STRATEGY:We searched the Cochrane Effective Practice and Organisation of Care Group (EPOC) specialised register and pending files until end of December 2002. English language articles only were included. SELECTION CRITERIA:Randomised controlled trials (RCTs) that reported objectively measured professional practice or health care outcomes in which at least one group received an intervention designed (or tailored) to address prospectively identified barriers to change. DATA COLLECTION AND ANALYSIS:Two reviewers independently extracted data and assessed quality. We also contacted study authors to obtain any missing information. Quantitative and qualitative analyses were undertaken. MAIN RESULTS:We included 15 studies. For Comparison 1 (an intervention tailored to address identified barriers to change compared to no intervention or an intervention(s) not tailored to the barriers), there was no consistency in the results and the effect sizes varied both across and within studies.A meta-regression of a subset of the included studies, using a classical approach estimated a combined OR of 2.18 (95% CI: 1.09, 4.34), p = 0.026 in favour of tailored interventions. However, when a Bayesian approach was taken, meta-regression gave a combined OR of 2.27 (95% Credible Interval: 0.92, 4.75), which was not statistically significant. AUTHORS' CONCLUSIONS:Interventions tailored to prospectively identify barriers may improve care and patient outcomes. However, from the studies included in this review, we were unable to determine whether the barriers were valid, which were the most important barriers, whether all barriers were identified and if they had been addressed by the intervention chosen. Based on the evidence presented in this review, the effectiveness of tailored interventions remains uncertain and more rigorous trials (including process evaluations) are needed. Further research needs to address explicitly the questions of identifying and addressing barriers.

authors

Shaw B,Cheater F,Baker R,Gillies C,Hearnshaw H,Flottorp S,Robertson N

doi

10.1002/14651858.CD005470

keywords:

subject

Has Abstract

pub_date

2005-07-20 00:00:00

pages

CD005470

issue

3

issn

1469-493X

pub_type

杂志文章,meta分析,评审
  • Rituximab for eradicating inhibitors in people with acquired haemophilia A.

    abstract:BACKGROUND:Acquired haemophilia A is a rare bleeding disorder caused by the development of specific autoantibodies against coagulation factor VIII. Rituximab may be an alternative approach to the treatment of acquired haemophilia by eradicating FVIII autoantibodies. OBJECTIVES:To assess and summarise the efficacy and ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD011907.pub2

    authors: Zeng Y,Zhou R,Duan X,Long D

    更新日期:2016-07-08 00:00:00

  • Moderately early (7-14 days) postnatal corticosteroids for preventing chronic lung disease in preterm infants.

    abstract:BACKGROUND:Corticosteroids have been used late in the neonatal period to treat chronic lung disease (CLD) in preterm babies, and early to try to prevent it. CLD is likely to be the result of persisting inflammation in the lung and the use of powerful anti-inflammatory drugs like dexamethasone has some rationale. Early ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001144

    authors: Halliday HL,Ehrenkranz RA,Doyle LW

    更新日期:2003-01-01 00:00:00

  • Patient education for preventing diabetic foot ulceration.

    abstract:BACKGROUND:Ulceration of the feet, which can result in loss of limbs and even death, is one of the major health problems for people with diabetes mellitus. OBJECTIVES:To assess the effects of patient education on the prevention of foot ulcers in patients with diabetes mellitus. SEARCH METHODS:We searched The Cochrane...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001488.pub5

    authors: Dorresteijn JA,Kriegsman DM,Assendelft WJ,Valk GD

    更新日期:2014-12-16 00:00:00

  • Adjuvant radiotherapy for stage I endometrial cancer.

    abstract:BACKGROUND:This is an updated version of the original Cochrane review published in Issue 2, 2007. The role of radiotherapy (both pelvic external beam radiotherapy (EBRT) and vaginal intracavity brachytherapy (VBT)) in stage I endometrial cancer following hysterectomy remains controversial. OBJECTIVES:To assess the eff...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003916.pub3

    authors: Kong A,Johnson N,Kitchener HC,Lawrie TA

    更新日期:2012-03-14 00:00:00

  • Immunosuppressant and immunomodulatory treatments for multifocal motor neuropathy.

    abstract:BACKGROUND:Multifocal motor neuropathy (MMN) is characterised by progressive, predominantly distal, asymmetrical limb weakness and usually multiple partial motor nerve conduction blocks. Intravenous immunoglobulin (IVIg) is beneficial but the role of immunosuppressive agents is uncertain. This is an update of a review ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003217.pub5

    authors: Umapathi T,Hughes RA,Nobile-Orazio E,Léger JM

    更新日期:2015-03-04 00:00:00

  • Voxel-based morphometry for separation of schizophrenia from other types of psychosis in first episode psychosis.

    abstract:BACKGROUND:Schizophrenia is a psychiatric disorder which involves distortions in thought and perception, blunted affect, and behavioural disturbances. The longer psychosis goes unnoticed and untreated, the more severe the repercussions for relapse and recovery. There is some evidence that early intervention services ca...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD011021.pub2

    authors: Palaniyappan L,Maayan N,Bergman H,Davenport C,Adams CE,Soares-Weiser K

    更新日期:2015-08-07 00:00:00

  • Posterior versus lateral surgical approach for total hip arthroplasty in adults with osteoarthritis.

    abstract:BACKGROUND:Osteoarthritis (OA) of the hip is a progressive condition that has no cure and often requires a total hip arthroplasty (THA). The principal methods for THA are the posterior and direct lateral approaches. The posterior approach is considered to be easy to perform, however, increased rates of dislocation have...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003828.pub3

    authors: Jolles BM,Bogoch ER

    更新日期:2006-07-19 00:00:00

  • Midwife-led continuity models versus other models of care for childbearing women.

    abstract:BACKGROUND:Midwives are primary providers of care for childbearing women around the world. However, there is a lack of synthesised information to establish whether there are differences in morbidity and mortality, effectiveness and psychosocial outcomes between midwife-led continuity models and other models of care. O...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004667.pub4

    authors: Sandall J,Soltani H,Gates S,Shennan A,Devane D

    更新日期:2015-09-15 00:00:00

  • Vitamin C for preventing and treating tetanus.

    abstract:BACKGROUND:Tetanus is a severe infection that can be prevented by vaccination. In developing countries vaccination coverage is not always high and in developed countries cases may still occur, particularly in elderly people owing to their reduced immunoprotection. It has been estimated that there are about one million ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD006665.pub2

    authors: Hemilä H,Koivula TT

    更新日期:2008-04-16 00:00:00

  • Glucocorticoids for acute viral bronchiolitis in infants and young children.

    abstract:BACKGROUND:Previous systematic reviews have not shown clear benefit of glucocorticoids for acute viral bronchiolitis, but their use remains considerable. Recent large trials add substantially to current evidence and suggest novel glucocorticoid-including treatment approaches. OBJECTIVES:To review the efficacy and safe...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004878.pub3

    authors: Fernandes RM,Bialy LM,Vandermeer B,Tjosvold L,Plint AC,Patel H,Johnson DW,Klassen TP,Hartling L

    更新日期:2010-10-06 00:00:00

  • Group-based parent-training programmes for improving emotional and behavioural adjustment in 0-3 year old children.

    abstract:BACKGROUND:Mental health problems in children are common. Research suggests that parenting has an important role to play in helping children to become well adjusted adults, and that the first few months and years of a child's life are especially important in establishing patterns of emotional, cognitive and social func...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003680

    authors: Barlow J,Parsons J

    更新日期:2002-01-01 00:00:00

  • Hydration for treatment of preterm labour.

    abstract:BACKGROUND:Hydration has been proposed as a treatment for women with preterm labour. Theoretically, hydration may reduce uterine contractility by increasing uterine blood flow and by decreasing pituitary secretion of antidiuretic hormone and oxytocin. OBJECTIVES:To evaluate the effectiveness of intravenous or oral hyd...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003096.pub2

    authors: Stan CM,Boulvain M,Pfister R,Hirsbrunner-Almagbaly P

    更新日期:2013-11-04 00:00:00

  • Treatment for amphetamine withdrawal.

    abstract:BACKGROUND:Amphetamine withdrawal has been less studied although it is a common problem with a prevalent rate of 87% among amphetamine users. Its symptoms, in particular intense craving, may be a critical factor leading to relapse of amphetamine use. In clinical practice, treatment for cocaine withdrawal has been recom...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003021

    authors: Srisurapanont M,Jarusuraisin N,Kittirattanapaiboon P

    更新日期:2001-01-01 00:00:00

  • Levonorgestrel intrauterine system for endometrial protection in women with breast cancer on adjuvant tamoxifen.

    abstract:BACKGROUND:Adjuvant tamoxifen reduces the risk of breast cancer recurrence in women with estrogen receptor-positive breast cancer. Tamoxifen also increases the risk of postmenopausal bleeding, endometrial hyperplasia, polyps, and endometrial cancer. The levonorgestrel-releasing intrauterine system (LNG-IUS) causes prof...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD007245.pub2

    authors: Chin J,Konje JC,Hickey M

    更新日期:2009-10-07 00:00:00

  • Arginine supplementation for prevention of necrotising enterocolitis in preterm infants.

    abstract:BACKGROUND:Decreased concentration of nitric oxide has been proposed as one of the possible cellular mechanisms of necrotising enterocolitis (NEC). Arginine can act as a substrate for production of nitric oxide in the tissues, and arginine supplementation may help to prevent NEC. OBJECTIVES:To examine the effect of ar...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004339.pub4

    authors: Shah PS,Shah VS,Kelly LE

    更新日期:2017-04-11 00:00:00

  • Inhaled sodium cromoglycate for asthma in children.

    abstract:BACKGROUND:Sodium cromoglycate has been recommended as maintenance treatment for childhood asthma for many years. Its use has decreased since 1990, when inhaled corticosteroids became popular, but it is still used in many countries. OBJECTIVES:To determine the efficacy of sodium cromoglycate compared to placebo in the...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD002173.pub2

    authors: van der Wouden JC,Uijen JH,Bernsen RM,Tasche MJ,de Jongste JC,Ducharme F

    更新日期:2008-10-08 00:00:00

  • Skin preparation for preventing infection following caesarean section.

    abstract:BACKGROUND:The risk of maternal mortality and morbidity (particularly postoperative infection) is higher for caesarean section (CS) than for vaginal birth. With the increasing rate of CS, it is important to minimise the risks to the mother as much as possible. This review focused on different forms and methods of preop...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD007462.pub4

    authors: Hadiati DR,Hakimi M,Nurdiati DS,da Silva Lopes K,Ota E

    更新日期:2018-10-22 00:00:00

  • Flupenthixol versus placebo for schizophrenia.

    abstract:BACKGROUND:Flupenthixol, first made available in the UK in 1965, has been used as a treatment for schizophrenia for decades. OBJECTIVES:To evaluate the absolute clinical effects of flupenthixol for schizophrenia in comparison with placebo. SEARCH METHODS:We searched the Cochrane Schizophrenia Group Trials Register (A...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD009777.pub2

    authors: Shen X,Xia J,Adams CE

    更新日期:2012-11-14 00:00:00

  • Desmopressin for nocturnal enuresis in children.

    abstract:BACKGROUND:Enuresis (bedwetting) is a socially disruptive and stressful condition which affects around 15-20% of five year olds, and up to 2% of young adults. Although there is a high rate of spontaneous remission, the social, emotional and psychological costs to the children can be great. OBJECTIVES:To assess the eff...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002112

    authors: Glazener CM,Evans JH

    更新日期:2000-01-01 00:00:00

  • Perioperative ketamine for acute postoperative pain.

    abstract:BACKGROUND:Postoperative pain management is often limited by adverse effects such as nausea and vomiting. Adjuvant treatment with an inexpensive opioid-sparing drug such as ketamine may be of value in giving better analgesia with fewer adverse effects. OBJECTIVES:To evaluate the effectiveness and tolerability of ketam...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004603.pub2

    authors: Bell RF,Dahl JB,Moore RA,Kalso E

    更新日期:2006-01-25 00:00:00

  • Methotrexate for induction of remission in refractory Crohn's disease.

    abstract:BACKGROUND:Although corticosteroids are effective for induction of remission of Crohn's disease, many patients relapse when steroids are withdrawn or become steroid dependent. Furthermore, corticosteroids exhibit significant adverse effects. The success of methotrexate as a treatment for rheumatoid arthritis led to its...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003459.pub4

    authors: McDonald JW,Wang Y,Tsoulis DJ,MacDonald JK,Feagan BG

    更新日期:2014-08-06 00:00:00

  • Interventions for treating intrahepatic cholestasis in people with sickle cell disease.

    abstract:BACKGROUND:Sickle cell disease is the most common hemoglobinopathy occurring worldwide and sickle cell intrahepatic cholestasis is a complication long recognized in this population. Cholestatic liver diseases are characterized by impaired formation or excretion (or both) of bile from the liver. There is a need to asses...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD010985.pub3

    authors: Martí-Carvajal AJ,Martí-Amarista CE

    更新日期:2017-07-31 00:00:00

  • Botulinum toxin type A versus botulinum toxin type B for cervical dystonia.

    abstract:BACKGROUND:Cervical dystonia is the most common form of focal dystonia. It is characterized by involuntary posturing of the head and frequently is associated with neck pain. Disability and social withdrawal are common. Most cases are idiopathic, and generally it is a life-long disorder. In recent years, botulinum toxin...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004314.pub2

    authors: Costa J,Borges A,Espírito-Santo C,Ferreira J,Coelho M,Moore P,Sampaio C

    更新日期:2005-01-25 00:00:00

  • Interventions for preventing tobacco sales to minors.

    abstract:BACKGROUND:Laws restricting sales of tobacco products to minors exist in many countries, but young people may still purchase cigarettes easily. OBJECTIVES:The review assesses the effects of interventions to reduce underage access to tobacco by deterring shopkeepers from making illegal sales. SEARCH STRATEGY:We search...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001497.pub2

    authors: Stead LF,Lancaster T

    更新日期:2005-01-25 00:00:00

  • Aripiprazole versus other atypical antipsychotics for schizophrenia.

    abstract:BACKGROUND:In most western industrialised countries, second generation (atypical) antipsychotics are recommended as first line drug treatments for people with schizophrenia. In this review we specifically examine how the efficacy and tolerability of one such agent - aripiprazole - differs from that of other comparable ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006569.pub4

    authors: Khanna P,Komossa K,Rummel-Kluge C,Hunger H,Schwarz S,El-Sayeh HG,Leucht S

    更新日期:2013-02-28 00:00:00

  • Vitamin supplementation for preventing miscarriage.

    abstract:BACKGROUND:Miscarriage is a common complication of pregnancy that can be caused by a wide range of factors. Poor dietary intake of vitamins has been associated with an increased risk of miscarriage, therefore supplementing women with vitamins either prior to or in early pregnancy may help prevent miscarriage. OBJECTIV...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004073.pub3

    authors: Rumbold A,Middleton P,Pan N,Crowther CA

    更新日期:2011-01-19 00:00:00

  • Urate oxidase for the prevention and treatment of tumor lysis syndrome in children with cancer.

    abstract:BACKGROUND:Tumor lysis syndrome (TLS) is a serious complication of malignancies and can result in renal failure or death. Preliminary reports suggest that urate oxidase is highly effective in reducing serum uric acid. It is uncertain whether high quality evidence exists to support its routine use in children with malig...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006945.pub2

    authors: Cheuk DK,Chiang AK,Chan GC,Ha SY

    更新日期:2010-06-16 00:00:00

  • Adenosine versus intravenous calcium channel antagonists for the treatment of supraventricular tachycardia in adults.

    abstract:BACKGROUND:Patients with paroxysmal supraventricular tachycardia frequently present to the Emergency Department. Where vagal manoeuvres fail, the two most commonly used drugs are adenosine and calcium channel antagonists. Both are known to be effective but both have a significant side-effect profile. OBJECTIVES:To exa...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005154.pub2

    authors: Holdgate A,Foo A

    更新日期:2006-10-18 00:00:00

  • Early treatment versus expectant management of hemodynamically significant patent ductus arteriosus for preterm infants.

    abstract:BACKGROUND:Patent ductus arteriosus (PDA) is associated with significant morbidity and mortality in preterm infants. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to prevent or treat a PDA. There are concerns regarding adverse effects of NSAIDs in preterm infants. Controversy exists on whether early targeted t...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD013278.pub2

    authors: Mitra S,Scrivens A,von Kursell AM,Disher T

    更新日期:2020-12-10 00:00:00

  • Granulocyte transfusions for treating infections in patients with neutropenia or neutrophil dysfunction.

    abstract:BACKGROUND:Transfusions of granulocytes have a long history of usage in clinical practice to support and treat severe infection in high risk groups of patients with neutropenia or neutrophil dysfunction. However, there is considerable current variability in therapeutic granulocyte transfusion practice, and uncertainty ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005339

    authors: Stanworth SJ,Massey E,Hyde C,Brunskill S,Lucas G,Navarrete C,Marks DI

    更新日期:2005-07-20 00:00:00