PMID- 37344115
OWN - NLM
STAT- MEDLINE
DCOM- 20230623
LR  - 20230704
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 13
IP  - 6
DP  - 2023 Jun 21
TI  - Understanding factors influencing the use of clinical guidelines in low-income 
      and middle-income settings: a scoping review.
PG  - e070399
LID - 10.1136/bmjopen-2022-070399 [doi]
LID - e070399
AB  - OBJECTIVE: A scoping review was undertaken to determine the extent to which 
      existing studies have examined factors influencing healthcare providers' use of 
      clinical guidelines in low and middle-income country (LMIC) settings and 
      determine which factors constrain or facilitate the use of clinical guidelines by 
      healthcare providers. DESIGN: Scoping review. DATA SOURCES: The literature search 
      was conducted using PubMed in January 2021. ELIGIBILITY CRITERIA: We identified 
      empirical studies, published between 2011-2021 in English, which included 
      clinicians and/or nurses as healthcare providers, used a health facility as the 
      study site, and were located in an LMIC. DATA EXTRACTION AND SYNTHESIS: 
      Information extracted from the literature review was organised using themes and 
      the findings synthesised using thematic analysis. RESULTS: The review identified 
      five types of interacting factors that influence healthcare providers' use of and 
      compliance with clinical guidelines. The factors identified are organisational 
      factors, factors relating to individual healthcare providers, attributes of the 
      clinical guidelines, patient-related factors and institutional factors. 
      Organisational factors can be further divided into the physical work environment, 
      organisational culture and working conditions. The effective use of clinical 
      guidelines in LMIC settings is greatly impacted by the contextualisation of 
      clinical guidelines, end-user engagement and alignment of the implementation of 
      clinical guidelines with the institutional arrangements in the broader health 
      system. CONCLUSION: The development and evaluation of concrete interventions is 
      vital to facilitate the implementation of clinical guidelines and improve 
      healthcare service quality. Further studies are necessary to examine the relative 
      importance of the five identified factors on the effective use of clinical 
      guidelines in different contexts.
CI  - (c) Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Orangi, Stacey
AU  - Orangi S
AUID- ORCID: 0000-0002-3236-5229
AD  - Health Economics Research Unit (HERU), KEMRI-Wellcome Trust Research Programme, 
      Nairobi, Kenya sorangi@kemri-wellcome.org.
FAU - Orangi, Tiffany
AU  - Orangi T
AD  - Faculty of Epidemiology and Population Health, London School of Hygiene & 
      Tropical Medicine, London, UK.
FAU - Kabubei, Kenneth Munge
AU  - Kabubei KM
AD  - Health, Nutrition and Population, World Bank, Pretoria, South Africa.
FAU - Honda, Ayako
AU  - Honda A
AD  - Research Center for Health Policy and Economics, Hitotsubashi Institute for 
      Advanced Study, Hitotsubashi University, Tokyo, Japan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20230621
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
MH  - Humans
MH  - *Health Personnel
MH  - *Poverty
MH  - Income
PMC - PMC10314507
OTO - NOTNLM
OT  - Protocols & guidelines
OT  - Public health
OT  - Quality in health care
COIS- Competing interests: None declared.
EDAT- 2023/06/22 01:07
MHDA- 2023/06/23 06:42
PMCR- 2023/06/21
CRDT- 2023/06/21 21:03
PHST- 2023/06/23 06:42 [medline]
PHST- 2023/06/22 01:07 [pubmed]
PHST- 2023/06/21 21:03 [entrez]
PHST- 2023/06/21 00:00 [pmc-release]
AID - bmjopen-2022-070399 [pii]
AID - 10.1136/bmjopen-2022-070399 [doi]
PST - epublish
SO  - BMJ Open. 2023 Jun 21;13(6):e070399. doi: 10.1136/bmjopen-2022-070399.