Achieving change in primary care--causes of the evidence to practice gap: systematic reviews of reviews

Rosa Lau, Fiona Stevenson, Bie Nio Ong, Krysia Dziedzic, Shaun Treweek, Sandra Eldridge, Hazel Everitt, Anne Kennedy, Nadeem Qureshi, Anne Rogers, Richard Peacock, Elizabeth Murray, Rosa Lau, Fiona Stevenson, Bie Nio Ong, Krysia Dziedzic, Shaun Treweek, Sandra Eldridge, Hazel Everitt, Anne Kennedy, Nadeem Qureshi, Anne Rogers, Richard Peacock, Elizabeth Murray

Abstract

Background: This study is to identify, summarise and synthesise literature on the causes of the evidence to practice gap for complex interventions in primary care.

Design: This study is a systematic review of reviews.

Methods: MEDLINE, EMBASE, CINAHL, Cochrane Library and PsychINFO were searched, from inception to December 2013. Eligible reviews addressed causes of the evidence to practice gap in primary care in developed countries. Data from included reviews were extracted and synthesised using guidelines for meta-synthesis.

Results: Seventy reviews fulfilled the inclusion criteria and encompassed a wide range of topics, e.g. guideline implementation, integration of new roles, technology implementation, public health and preventative medicine. None of the included papers used the term "cause" or stated an intention to investigate causes at all. A descriptive approach was often used, and the included papers expressed "causes" in terms of "barriers and facilitators" to implementation. We developed a four-level framework covering external context, organisation, professionals and intervention. External contextual factors included policies, incentivisation structures, dominant paradigms, stakeholders' buy-in, infrastructure and advances in technology. Organisation-related factors included culture, available resources, integration with existing processes, relationships, skill mix and staff involvement. At the level of individual professionals, professional role, underlying philosophy of care and competencies were important. Characteristics of the intervention that impacted on implementation included evidence of benefit, ease of use and adaptability to local circumstances. We postulate that the "fit" between the intervention and the context is critical in determining the success of implementation.

Conclusions: This comprehensive review of reviews summarises current knowledge on the barriers and facilitators to implementation of diverse complex interventions in primary care. To maximise the uptake of complex interventions in primary care, health care professionals and commissioning organisations should consider the range of contextual factors, remaining aware of the dynamic nature of context. Future studies should place an emphasis on describing context and articulating the relationships between the factors identified here.

Systematic review registration: PROSPERO CRD42014009410.

Keywords: Barriers; Complex interventions; Evidence-based practice; Facilitators; Health services research; Implementation research; Primary care; Systematic review.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram
Fig. 2
Fig. 2
Conceptual framework describing key elements that influence implementation of change in primary care
Fig. 3
Fig. 3
Practical implications of the results of the synthesis—recommendations when planning implementation

References

    1. Department of Health, innovation, health and wealth: accelerating adoption and diffusion in the NHS. 2011 Dec. . Accessed 20 Oct 2015.
    1. England NHS. Five year forward view. 2014.
    1. Mickan S, Burls A, Glasziou P. Patterns of ‘leakage’ in the utilisation of clinical guidelines: a systematic review. Postgrad Med J. 2011;87(1032):670–9. doi: 10.1136/pgmj.2010.116012.
    1. Sederer LI. Science to practice: making what we know what we actually do. Schizophr Bull. 2009;35(4):714–8. doi: 10.1093/schbul/sbp040.
    1. Runciman WB, Hunt TD, Hannaford NA, Hibbert PD, Westbrook JI, Coiera EW, et al. CareTrack: assessing the appropriateness of health care delivery in Australia. Med J Aust. 2012;197(2):100–5. doi: 10.5694/mja12.10510.
    1. Grol R, Grimshaw J. From best evidence to best practice: effective implementation of change in patients’ care. Lancet. 2003;362(9391):1225–30. doi: 10.1016/S0140-6736(03)14546-1.
    1. Woolf SH. The meaning of translational research and why it matters. JAMA. 2008;299(2):211–3. doi: 10.1001/jama.2007.26.
    1. Health & Social Care Information Centre (HSCIC). . Accessed 20 Jan 2016.
    1. NHS England (London region)/primary care transformation programme. Transforming primary care in London: general practice—a call to action. 2013. . Accessed 12 Nov 2015.
    1. Salmon P, Peters S, Rogers A, Gask L, Clifford R, Iredale W, et al. Peering through the barriers in GPs’ explanations for declining to participate in research: the role of professional autonomy and the economy of time. Fam Pract. 2007;24(3):269–75. doi: 10.1093/fampra/cmm015.
    1. Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ. 2008;337:a1655. doi: 10.1136/bmj.a1655.
    1. Smith V, Devane D, Begley CM, Clarke M. Methodology in conducting a systematic review of systematic reviews of healthcare interventions. BMC Med Res Methodol. 2011;11(1):15. doi: 10.1186/1471-2288-11-15.
    1. Mair FS, May C, O’Donnell C, Finch T, Sullivan F, Murray E. Factors that promote or inhibit the implementation of e-health systems: an explanatory systematic review. Bull World Health Organ. 2012;90(5):357–64. doi: 10.2471/BLT.11.099424.
    1. Gagnon MP, Nsangou ER, Payne-Gagnon J, Grenier S, Sicotte C. Barriers and facilitators to implementing electronic prescription: a systematic review of user groups’ perceptions. J Am Med Inform Assoc. 2014;21(3):535–41. doi: 10.1136/amiajnl-2013-002203.
    1. Novins DK, Green AE, Legha RK, Aarons GA. Dissemination and implementation of evidence-based practices for child and adolescent mental health: a systematic review. Journal of the American Academy of Child and Adolescent Psychiatry 2013;52(10):1009-1025.
    1. Addington D, Kyle T, Desai S, Wang J. Facilitators and barriers to implementing quality measurement in primary mental health care: systematic review. [Review] Canadian Family Physician. 2010;56(12):1322–31.
    1. Adaji A, Schattner P, Jones K. The use of information technology to enhance diabetes management in primary care: a literature review. Informatics in Primary Care. 2008;16(3):2008.
    1. Royal College of General Practitioners. The future direction of general practice, a roadmap. London: RCGP. 2007. . Accesseed 12 Nov 2015.
    1. The organisation for economic co-operation and development (OECD). List of current members and partners. 2016. . Accessed 20 Jan 2016.
    1. Linton JD. Implementation research: state of the art and future directions. Technovation. 2002;22(2):65–79. doi: 10.1016/S0166-4972(01)00075-X.
    1. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med. 2009;151(4):W65–W94. doi: 10.7326/0003-4819-151-4-200908180-00136.
    1. Lau R, Stevenson F, Ong BN, Dziedzic K, Eldridge S, Everitt H, et al. Addressing the evidence to practice gap for complex interventions in primary care: a systematic review of reviews protocol. BMJ Open. 2014;4(6):e005548. doi: 10.1136/bmjopen-2014-005548.
    1. Noblit GW, Hare RD. Meta-ethnography: synthesizing qualitative studies. Newbury Park: Sage; 1988.
    1. Walsh D, Downe S. Meta-synthesis method for qualitative research: a literature review. J Adv Nurs. 2005;50(2):204–11. doi: 10.1111/j.1365-2648.2005.03380.x.
    1. Jensen LA, Allen MN. Meta-synthesis of qualitative findings. Qualitative Health Research. 1996;6(4):553–60. doi: 10.1177/104973239600600407.
    1. Campbell R, Pound P, Morgan M, Daker-White G, Britten N, Pill R, et al. Evaluating meta-ethnography: systematic analysis and synthesis of qualitative research. Health Technol Assess. 2011;15(43):1–164. doi: 10.3310/hta15430.
    1. Tong A, Flemming K, McInnes E, Oliver S, Craig J. Enhancing transparency in reporting the synthesis of qualitative research: ENTREQ. BMC Med Res Methodol. 2012;12:181. doi: 10.1186/1471-2288-12-181.
    1. Checkland K, Harrison S, Marshall M. Is the metaphor of ‘barriers to change’ useful in understanding implementation? Evidence from general medical practice. J Health Serv Res Policy. 2007;12(2):95–100. doi: 10.1258/135581907780279657.
    1. Public Health Resource Unit . Critical appraisal skills programme. 10 questions to help you make sense of qualitative research. England: Public Health Resource Unit; 2006.
    1. Pluye P, Gagnon MP, Griffiths F, Johnson-Lafleur J. A scoring system for appraising mixed methods research, and concomitantly appraising qualitative, quantitative and mixed methods primary studies in mixed studies reviews. Int J Nurs Stud. 2009;46(4):529–46. doi: 10.1016/j.ijnurstu.2009.01.009.
    1. Gagnon MP, Desmartis M, Labrecque M, Car J, Pagliari C, Pluye P, et al. Systematic review of factors influencing the adoption of information and communication technologies by healthcare professionals. J Med Syst. 2012;36(1):241–77. doi: 10.1007/s10916-010-9473-4.
    1. Durlak JA, DuPre EP. Implementation matters: a review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am J Community Psychol. 2008;41(3–4):327–50. doi: 10.1007/s10464-008-9165-0.
    1. Mason A. New medicines in primary care: a review of influences on general practitioner prescribing. Journal of Clinical Pharmacy and Therapeutics 2008;33(1):1-10.
    1. Broens TH, Huis in’t Veld RM, Vollenbroek-Hutten MM, Hermens HJ, van Halteren AT, Nieuwenhuis LJ. Determinants of successful telemedicine implementations: a literature study. J Telemed Telecare. 2007;13(6):303–9. doi: 10.1258/135763307781644951.
    1. Dulko D. Audit and feedback as a clinical practice guideline implementation strategy: a model for acute care nurse practitioners. Worldviews on Evidence-Based Nursing. 2007;4(4):200-9.
    1. Nilsen P, Aalto M, Bendtsen P, Seppa K. Effectiveness of strategies to implement brief alcohol intervention in primary healthcare. A systematic review. [Review] [47 refs] Scandinavian Journal of Primary Health Care. 2006;24(1):5–15. doi: 10.1080/02813430500475282.
    1. Peleg M, Tu S. Decision support, knowledge representation and management in medicine. Yearb Med Inform. 2006;72–80.
    1. McKenna H, Ashton S, Keeney S. Barriers to evidence based practice in primary care: a review of the literature. [Review] [72 refs] International Journal of Nursing Studies. 2004;41(4):369–78. doi: 10.1016/j.ijnurstu.2003.10.008.
    1. Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud PA, et al. Why don't physicians follow clinical practice guidelines? A framework for improvement. JAMA. 1999;282(15):1458–65. doi: 10.1001/jama.282.15.1458.
    1. Fitzpatrick LA, Melnikas AJ, Weathers M, Kachnowski SW. Understanding communication capacity. Communication patterns and ICT usage in clinical settings. J Healthc Inf Manag. 2008;22(3):34–41.
    1. Leatt P, Shea C, Studer M, Wang V. IT solutions for patient safety—best practices for successful implementation in healthcare. Healthc Q. 2006;9(1):94–104.
    1. Lu YC, Xiao Y, Sears A, Jacko JA. A review and a framework of handheld computer adoption in healthcare. Int J Med Inform. 2005;74(5):409–22. doi: 10.1016/j.ijmedinf.2005.03.001.
    1. Yarbrough AK, Smith TB. Technology acceptance among physicians: a new take on TAM. Med Care Res Rev. 2007;64(6):650–72. doi: 10.1177/1077558707305942.
    1. Yusof MM, Stergioulas L, Zugic J. Health information systems adoption: findings from a systematic review. Stud Health Technol Inform. 2007;129(Pt 1):262–6.
    1. Rogers E. Diffusion of innovations. 5th edition ed. New York: Free Press; 2003.
    1. May C, Finch T. Implementing, embedding and integrating practices: an outline of Normalization Process Theory. Sociology. 2009;43(3):535–554. doi: 10.1177/0038038509103208.
    1. Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:50. doi: 10.1186/1748-5908-4-50.
    1. Legris P, Ingham J, Collerette P. Why do people use information technology? A critical review of the technology acceptance model. Information & Management. 2003;40(3):191–204. doi: 10.1016/S0378-7206(01)00143-4.
    1. Kitson A, Harvey G, McCormack B. Enabling the implementation of evidence based practice: a conceptual framework. Qual Health Care. 1998;7(3):149–58. doi: 10.1136/qshc.7.3.149.
    1. Helfrich C, Damschroder L, Hagedorn H, Daggett G, Sahay A, Ritchie M, et al. A critical synthesis of literature on the promoting action on research implementation in health services (PARIHS) framework. Implementation Science. 2010;5:82. doi: 10.1186/1748-5908-5-82.
    1. Fontaine P, Ross SE, Zink T, Schilling LM. Systematic review of health information exchange in primary care practices. [Review] Journal of the American Board of Family Medicine: JABFM. 2010;23(5):655–70. doi: 10.3122/jabfm.2010.05.090192.
    1. Ogundele M. Challenge of introducing evidence based medicine into clinical practice : An example of local initiatives in paediatrics. Clinical Governance. 2011;16(3):2011. doi: 10.1108/14777271111153859.
    1. Hoare KJ, Mills J, Francis K. The role of government policy in supporting nurse-led care in general practice in the United Kingdom, New Zealand and Australia: an adapted realist review. [References]. J Adv Nurs. 2012;68(5):963–80.
    1. Sangster-Gormley E, Martin-Misener R, Downe-Wamboldt B, Dicenso A. Factors affecting nurse practitioner role implementation in Canadian practice settings: an integrative review. [Review] Journal of Advanced Nursing. 2011;67(6):1178–90. doi: 10.1111/j.1365-2648.2010.05571.x.
    1. Dicenso A, Bryant-Lukosius D, Martin-Misener R, Donald F, Abelson J, Bourgeault I, et al. Factors enabling advanced practice nursing role integration in Canada. [Review] Nursing leadership (Toronto, Ont) 2010;23:Spec-38.
    1. Jarvis-Selinger S, Chan E, Payne R, Plohman K, Ho K. Clinical telehealth across the disciplines: lessons learned. Telemed J E Health. 2008;14(7):720–5. doi: 10.1089/tmj.2007.0108.
    1. Eisner D, Zoller M, Rosemann T, Huber CA, Badertscher N, Tandjung R. Screening and prevention in Swiss primary care: a systematic review. International journal of general medicine. 2011;4:853–70.
    1. Lau F, Price M, Boyd J, Partridge C, Bell H, Raworth R. Impact of electronic medical record on physician practice in office settings: a systematic review. BMC Medical Informatics and Decision Making. 2012;12(10).
    1. Langberg JM, Brinkman WB, Lichtenstein PK, Epstein JN. Interventions to promote the evidence-based care of children with ADHD in primary-care settings. [Review] [36 refs] Expert Review of Neurotherapeutics. 2009;9(4):477–87. doi: 10.1586/ern.09.5.
    1. Taylor CA, Shaw RL, Dale J, French DP. Enhancing delivery of health behaviour change interventions in primary care: a meta-synthesis of views and experiences of primary care nurses. Patient Education and Counseling 2011;85(2):315-322.
    1. Johnson M, Jackson R, Guillaume L, Meier P, Goyder E. Barriers and facilitators to implementing screening and brief intervention for alcohol misuse: a systematic review of qualitative evidence. [Review] Journal of Public Health. 2011;33(3):412–21. doi: 10.1093/pubmed/fdq095.
    1. Berry JA, Coverston CR, Williams M. Make each patient count. The Nurse practitioner. 2008;33(2):42-7.
    1. Baker R, Camosso SJ, Gillies C, Shaw EJ, Cheater F, Flottorp S, et al. Tailored interventions to overcome identified barriers to change: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews. 2010;17(3):CD005470.
    1. Ohinmaa A. What lessons can be learned from telemedicine programmes in other countries? J Telemed Telecare. 2006;12(Suppl 2):S40–S44. doi: 10.1258/135763306778393135.
    1. Garg AX, Adhikari NK, McDonald H, Rosas-Arellano MP, Devereaux PJ, Beyene J, et al. Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: a systematic review. JAMA. 2005;293(10):1223–38. doi: 10.1001/jama.293.10.1223.
    1. Zwolsman S, Te PE, Hooft L, Wieringa-de WM, Van DN. Barriers to GPs’ use of evidence-based medicine: a systematic review. [Review] British Journal of General Practice. 2012;62(600):e511–e521. doi: 10.3399/bjgp12X652382.
    1. Johnston G, Crombie IK, Davies HT, Alder EM, Millard A. Reviewing audit: barriers and facilitating factors for effective clinical audit. [Review] [90 refs] Quality in Health Care. 2000;9(1):23–36. doi: 10.1136/qhc.9.1.23.
    1. Kendall E, Sunderland N, Muenchberger H, Armstrong K. When guidelines need guidance: considerations and strategies for improving the adoption of chronic disease evidence by general practitioners. Journal of Evaluation in Clinical Practice. 2009;15(6):1082–90. doi: 10.1111/j.1365-2753.2009.01147.x.
    1. Shekelle PG, Morton SC, Keeler EB. Costs and benefits of health information technology. Evid Rep Technol Assess (Full Rep). 2006;(132):1–71.
    1. Vedel I, Puts MTE, Monette M, Monette J, Bergman H. Barriers and facilitators to breast and colorectal cancer screening of older adults in primary care: a systematic review. Journal of Geriatric Oncology. 2011;2(2):85-98.
    1. Holm AL, Severinsson E. Chronic care model for the management of depression: synthesis of barriers to, and facilitators of, success. [Review] International Journal of Mental Health Nursing. 2012;21(6):513–23. doi: 10.1111/j.1447-0349.2012.00827.x.
    1. Pereira JA, Quach S, Heidebrecht CL, Quan SD, Kolbe F, Finkelstein M, et al. Barriers to the use of reminder/recall interventions for immunizations: a systematic review. [Review] BMC Medical Informatics & Decision Making. 2012;12:145. doi: 10.1186/1472-6947-12-145.
    1. Kawamoto K, Houlihan CA, Balas EA, Lobach DF. Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success. BMJ. 2005;330(7494):765. doi: 10.1136/bmj.38398.500764.8F.
    1. Mollon B, Chong J, Jr, Holbrook AM, Sung M, Thabane L, Foster G. Features predicting the success of computerized decision support for prescribing: a systematic review of randomized controlled trials. BMC Med Inform Decis Mak. 2009;9:11. doi: 10.1186/1472-6947-9-11.
    1. Parsons JE, Merlin TL, Taylor JE, Wilkinson D, Hiller JE. Evidence-based practice in rural and remote clinical practice: where is the evidence? Australian Journal of Rural Health. 2003;11(5):242-8.
    1. Johnson KB. Barriers that impede the adoption of pediatric information technology. Arch Pediatr Adolesc Med. 2001;155(12):1374–9. doi: 10.1001/archpedi.155.12.1374.
    1. Ludwick DA, Doucette J. Adopting electronic medical records in primary care: lessons learned from health information systems implementation experience in seven countries. International Journal of Medical Informatics. 2009;78(1):22–31. doi: 10.1016/j.ijmedinf.2008.06.005.
    1. Nam S, Chesla C, Stotts NA, Kroon L, Janson SL. Barriers to diabetes management: patient and provider factors. Diabetes Research and Clinical Practice. 2011;93(1):1-9.
    1. Koch T, Iliffe S, EVIDEM-ED p Rapid appraisal of barriers to the diagnosis and management of patients with dementia in primary care: a systematic review. [Review] [45 refs] BMC Family Practice. 2010;11:52. doi: 10.1186/1471-2296-11-52.
    1. Stead M, Angus K, Holme I, Cohen D, Tait G. PESCE European Research Team. Factors influencing European GPs’ engagement in smoking cessation: a multi-country literature review. [Review] [73 refs] British Journal of General Practice. 2009;59(566):682–90. doi: 10.3399/bjgp09X454007.
    1. Johnson BT, Scott-Sheldon LA, Carey MP. Meta-synthesis of health behavior change meta-analyses. American Journal of Public Health. 2010;100(11):2193–8. doi: 10.2105/AJPH.2008.155200.
    1. Hearn L, Miller M, Campbell-Pope R, Waters S. Preventing overweight and obesity in young children: synthesising the evidence for management and policy making. Perth: Child Health Promotion Research Centre; 2006.
    1. Wensing M, van der Weijden T, Grol R. Implementing guidelines and innovations in general practice: which interventions are effective? [Review] [166 refs] [Erratum appears in J Cell Physiol 1998 Dec;177(3):499]. British Journal of General Practice. 1998;48(427):991–7.
    1. Orwat C, Graefe A, Faulwasser T. Towards pervasive computing in health care—a literature review. BMC Med Inform Decis Mak. 2008;8:26. doi: 10.1186/1472-6947-8-26.
    1. Halcomb E, Davidson P, Daly J, Yallop J, Tofler G. Australian nurses in general practice based heart failure management: implications for innovative collaborative practice. [Review] [89 refs] European Journal of Cardiovascular Nursing. 2004;3(2):135–47. doi: 10.1016/j.ejcnurse.2004.02.002.
    1. Child S, Goodwin V, Garside R, Jones-Hughes T, Boddy K, Stein K. Factors influencing the implementation of fall-prevention programmes: a systematic review and synthesis of qualitative studies. [Review] Implementation Science. 2012;7:91. doi: 10.1186/1748-5908-7-91.
    1. Renders CM, Valk GD, Griffin SJ, Wagner EH, Van Eijk JT, Assendelft WJ. Interventions to improve the management of diabetes in primary care, outpatient, and community settings: a systematic review. [Review] [74 refs] Diabetes Care. 2001;24(10):1821–33. doi: 10.2337/diacare.24.10.1821.
    1. Grilli R, Lomas J. Evaluating the message: the relationship between compliance rate and the subject of a practice guideline. Med Care. 1994;32(3):202–13. doi: 10.1097/00005650-199403000-00002.
    1. Davis DA, Taylor-Vaisey A. Translating guidelines into practice: a systematic review of theoretic concepts, practical experience and research evidence in the adoption of clinical practice guidelines. Can Med Assoc J. 1997;157:408–16.
    1. Jimison H, Gorman P, Woods S, Nygren P, Walker M, Norris S, et al. Barriers and drivers of health information technology use for the elderly, chronically ill, and underserved. Evid Rep Technol Assess (Full Rep). 2008;(175):1–1422
    1. Finch T, May C. Implementation, embedding and integration: an outline of Normalization Process Theory. Sociology. 2009;43(3):535–54. doi: 10.1177/0038038509103208.
    1. May C, Mair F, Finch T, Macfarlane A, Dowrick C, Treweek S, et al. Development of a theory of implementation and integration: Normalization Process Theory. Implement Sci. 2009;4:29–4. doi: 10.1186/1748-5908-4-29.
    1. Michie S, Johnston M, Abraham C, Lawton R, Parker D, Walker A. Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care. 2005;14(1):26–33. doi: 10.1136/qshc.2004.011155.
    1. Hage E, Roo JP, van Offenbeek MA, Boonstra A. Implementation factors and their effect on e-Health service adoption in rural communities: a systematic literature review. BMC Health Serv Res. 2013;13:19. doi: 10.1186/1472-6963-13-19.
    1. Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q. 2004;82(4):581–629. doi: 10.1111/j.0887-378X.2004.00325.x.
    1. Bate P, Robert G, Fulop N, Ovretveit J, Dixon-Woods M. Perspectives on context. London: Health Foundation; 2014.
    1. Moore GF, Audrey S, Barker M, Bond L, Bonell C, Hardeman W, et al. Process evaluation of complex interventions: Medical Research Council guidance. BMJ. 2015;350:h1258. doi: 10.1136/bmj.h1258.
    1. Popay J, editor. Moving beyond effectiveness in evidence synthesis. Methodological issues in the synthesis of diverse sources of evidence. London: National Institute for Health and Clinical Excellence; 2006.
    1. Armstrong D, Gosling A, Weinman J, Marteau T. The place of inter-rater reliability in qualitative research: an empirical study. Sociology. 1997;31(3):597–606. doi: 10.1177/0038038597031003015.
    1. Lineker SC, Husted JA. Educational interventions for implementation of arthritis clinical practice guidelines in primary care: effects on health professional behavior. [Review] Journal of Rheumatology. 2010;37(8):1562–9. doi: 10.3899/jrheum.100045.
    1. Lovell A, Yates P. Advance care planning in palliative care: a systematic literature review of the contextual factors influencing its uptake 2008–2012. Palliat Med. 2014;28(8):1026–35. doi: 10.1177/0269216314531313.
    1. Sales AE, Bostrom AM, Bucknall T, Draper K, Fraser K, Schalm C, et al. The use of data for process and quality improvement in long term care and home care: a systematic review of the literature. [Review] Journal of the American Medical Directors Association. 2012;13(2):103–13. doi: 10.1016/j.jamda.2011.01.004.
    1. Zhang JA, Neidlinger S. System barriers associated with diabetes management in primary care. Journal for Nurse Practitioners. 2012;8(10)):822–7. doi: 10.1016/j.nurpra.2012.02.025.
    1. [105] Zwar N, Harris M, Griffiths R, Roland M, Dennis S, Davies GP, et al. A systematic review of chronic disease management. Research Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, UNSW. 2006
    1. Saliba V, Legido-Quigley H, Hallik R, Aaviksoo A, Car J, McKee M. Telemedicine across borders: a systematic review of factors that hinder or support implementation. Int J Med Inform. 2012;81(12):793–809. doi: 10.1016/j.ijmedinf.2012.08.003.
    1. Waller R, Gilbody S. Barriers to the uptake of computerized cognitive behavioural therapy: a systematic review of the quantitative and qualitative evidence. Psychol Med. 2009;39(5):705–12. doi: 10.1017/S0033291708004224.
    1. Zheng MY, Suneja A, Chou AL, Arya M. Physician barriers to successful implementation of US Preventive Services Task Force routine HIV testing recommendations. J Int Assoc Provid AIDS Care. 2014;13(3):200–5. doi: 10.1177/2325957413514276.
    1. Clarin OA. Strategies to overcome barriers to effective nurse practitioner and physician collaboration. Journal for Nurse Practitioners. 2007;3(8):538–48. doi: 10.1016/j.nurpra.2007.05.019.
    1. Davies SL, Goodman C. A systematic review of integrated working between care homes and health care services. BMC Health Services Research. 2011;11:320. doi: 10.1186/1472-6963-11-320.
    1. Xyrichis A, Lowton K. What fosters or prevents interprofessional teamworking in primary and community care? A literature review. [Review] [60 refs] International Journal of Nursing Studies. 2008;45(1):140–53. doi: 10.1016/j.ijnurstu.2007.01.015.

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