Preventing vascular disease - effective strategies for implementing guidelines in general practice.

BACKGROUND: Prevention of vascular disease is an important and challenging role for general practice. Various professional bodies in Australia have published best practice guidelines that address the major behavioural and physiological risk factors for vascular disease. Although these guidelines provide consistent advice and have been widely disseminated, they have not been systematically implemented.
OBJECTIVE: This article presents findings from a literature review that identified effective strategies for implementing guidelines. DISCUSSION: Interventions that support guideline implementation are informed by theory, are multifaceted, tailored to barriers (at the patient, provider and practice levels) and the local context, and involve the entire primary healthcare team. Effective strategies include small group education, clinician prompts and decision aids, audit and feedback and external facilitation. The effectiveness of these strategies in different contexts varies. New systems or tools must fit well within the usual work routines if they are to be successful.