title: Benchmarking progress in the implementation of the Fourth Joint Societies' Task Force Guidelines on the Prevention of Cardiovascular Disease in Clinical Practice.
abstract: BACKGROUND
  The Fourth Joint Societies' Task Force (4th JTF) Guidelines on Cardiovascular Disease Prevention in Clinical Practice are agreed, evidence-based standards of care across European countries and professions. In advance of the publication of the 5th JTF Guidelines in 2012, this work assesses the extent to which the 4th JTF guidelines have been implemented.
  
  
  METHODS
  Qualitative study of guideline implementation in 13 European countries, focusing on the themes of guideline implementation structures, processes, and outcomes.
  
  
  METHODS
  Key personnel in 13 selected countries completed interviews or comparable questionnaires: they were national coordinators for CVD prevention (n = 14) and representatives of the national cardiac society (n = 9), heart foundations (n = 11), health ministry (n = 8), and service providers (n = 3). Interview and service-related data from each country were compiled to provide a detailed overview.
  
  
  RESULTS
  Ten of the 13 countries used European Society of Cardiology (ESC) guidelines on prevention at a national level, where three broad approaches to implementation were identified. In all 10 countries, multidisciplinary alliances oversaw implementation, but ongoing promotion of the guidelines was not evident, with just two of the 10 countries conducting evaluation of implementation. Barriers to implementation included weak health authority support, the unwieldy nature of the guidelines, guideline fatigue, and the lesser role of prevention in national healthcare systems.
  
  
  CONCLUSIONS
  Substantial progress had been made in implementing the guidelines, but countries struggled with the task. Some rebalancing of the ESC focus may be warranted so that part of the effort dedicated to improving guidelines might be redirected at translating them into practice.
authors.affiliation: Royal College of Surgeons in Ireland, Dublin, Ireland. kmorgan@rcsi.ie
authors.forename: Karen
authors.initials: K
authors.lastname: Morgan
authors.forename: Helen
authors.initials: H
authors.lastname: Burke
authors.forename: Hannah
authors.initials: H
authors.lastname: McGee
mesh_terms: D026683:Advisory Committees; D019985:Benchmarking / Q000592:standards*; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D005060:Europe; D005069:Evaluation Studies as Topic; D019983:Guideline Adherence; D006801:Humans; D033183:Interdisciplinary Communication; D017410:Practice Guidelines as Topic / Q000592:standards*; D012955:Societies, Medical; D011795:Surveys and Questionnaires