title: Barriers and Strategies in Guideline Implementation-A Scoping Review.
abstract: Research indicates that clinical guidelines are often not applied. The success of their implementation depends on the consideration of a variety of barriers and the use of adequate strategies to overcome them. Therefore, this scoping review aims to describe and categorize the most important barriers to guideline implementation. Furthermore, it provides an overview of different kinds of suitable strategies that are tailored to overcome these barriers. The search algorithm led to the identification of 1659 articles in PubMed. Overall, 69 articles were included in the data synthesis. The content of these articles was analysed by using a qualitative synthesis approach, to extract the most important information on barriers and strategies. The barriers to guideline implementation can be differentiated into personal factors, guideline-related factors, and external factors. The scoping review revealed the following aspects as central elements of successful strategies for guideline implementation: dissemination, education and training, social interaction, decision support systems and standing orders. Available evidence indicates that a structured implementation can improve adherence to guidelines. Therefore, the barriers to guideline implementation and adherence need to be analysed in advance so that strategies that are tailored to the specific setting and target groups can be developed.
authors.affiliation: Department of Public Health Medicine, School of Public Health, Bielefeld University, 33615 Bielefeld, Germany. f.fischer@uni-bielefeld.de.
authors.forename: Florian
authors.initials: F
authors.lastname: Fischer
authors.affiliation: Department of Public Health Medicine, School of Public Health, Bielefeld University, 33615 Bielefeld, Germany. kerstin.lange@uni-bielefeld.de.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Lange
authors.affiliation: Department of Health Care Management, School of Public Health, Bielefeld University, 33615 Bielefeld, Germany. kristina.klose@uni-bielefeld.de.
authors.forename: Kristina
authors.initials: K
authors.lastname: Klose
authors.affiliation: Department of Health Care Management, School of Public Health, Bielefeld University, 33615 Bielefeld, Germany. wolfgang.greiner@uni-bielefeld.de.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Greiner
authors.affiliation: Department of Public Health Medicine, School of Public Health, Bielefeld University, 33615 Bielefeld, Germany. alexander.kraemer@uni-bielefeld.de.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kraemer
keywords: barrier; guideline implementation; scoping review; strategy