Barriers and facilitators to implementation of APTA's breast cancer-related lymphedema diagnosis and intervention clinical practice guidelines.
Barriers
Breast cancer-related lymphedema
Clinical practice guidelines
Facilitators
Journal
Journal of cancer survivorship : research and practice
ISSN: 1932-2267
Titre abrégé: J Cancer Surviv
Pays: United States
ID NLM: 101307557
Informations de publication
Date de publication:
18 Oct 2023
18 Oct 2023
Historique:
received:
17
07
2023
accepted:
26
09
2023
medline:
19
10
2023
pubmed:
19
10
2023
entrez:
18
10
2023
Statut:
aheadofprint
Résumé
The purpose of this study was to identify barriers and facilitators influencing implementation of the diagnosis and intervention clinical practice guidelines (CPGs) related to the management of patients with breast cancer-related lymphedema (BCRL). A descriptive, cross-sectional web-based survey was conducted. Participants included physical therapists and assistants who were members of the APTA's Academy of Oncologic Physical Therapy and Lymphology Association of North America. Desriptive statisitcs were computed for all demographic and barriers and facilitators data. Individual exploratory factor analyses (EFA) were performed on survey items for both CPGs to identify themes of barriers and facilitators to implementation. A total of 180 respondents completed the survey. 34.9% of respondents read the diagnosis CPG and 22.4% read the intervention CPG. A total of 77.8% reported that they did not have issues in changing their clinical routines and 69.5% did not have resistance working according to CPGs. The EFA resulted in 3 themes for each CPG, accounting for 46% of the variance for the diagnostic CPG and 54% of the variance for the intervention CPG. The 3 themes, clinician characteristics, patient demographics, therapist practice setting and beliefs/values, were weighted differently for each EFA. Most respondents did not read either CPG, however, report a willingness to make changes to clinical practice and utilization of CPGs. For those who have attempted to implement the CPGs, this study was the first to identify the barriers and facilitators impacting the implementation of the CPGs related to the management of BCRL. The results will inform the development of targeted implementation strategies to improve access to and adherence to recommendations from the CPGs ultimately improving the efficiency and efficacy of care delivery to patients.
Identifiants
pubmed: 37853271
doi: 10.1007/s11764-023-01475-1
pii: 10.1007/s11764-023-01475-1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
APTA clinical practice guideline process manual, Revised. Alexandria, VA: American Physical Therapy Association; 2023.
Straus SE, Glasziou P, Richardson WS, Haynes RB. Evidence-based medicine: how to practice and teach EBM. 5th ed. Elsevier; 2019.
Graham R, Mancher M, Miller Wolman D, Greenfield S, E S. Clinical practice guidelines we can trust. National Academies Press (US); 2011.
Woolf SH, Grol R, Hutchinson A, Eccles M, Grimshaw J. Clinical guidelines: potential benefits, limitations, and harms of clinical guidelines. BMJ. 1999;318(7182):527–30. https://doi.org/10.1136/bmj.318.7182.527 .
doi: 10.1136/bmj.318.7182.527
pubmed: 10024268
pmcid: 1114973
Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud PA, Rubin HR. Why don’t physicians follow clinical practice guidelines? A framework for improvement JAMA. 1999;282(15):1458–65. https://doi.org/10.1001/jama.282.15.1458 .
doi: 10.1001/jama.282.15.1458
pubmed: 10535437
Rauh S, Arnold D, Braga S, Curca R, Eckert R, Fröbe A, Karamouzis M, Lakatos G, Molitor JL. Challenge of implementing clinical practice guidelines. Getting ESMO’s guidelines even closer to the bedside: introducing the ESMO Practising Oncologists’ checklists and knowledge and practice questions. ESMO Open. 2018;3(5):e000385–e000385. https://doi.org/10.1136/esmoopen-2018-000385 .
doi: 10.1136/esmoopen-2018-000385
pubmed: 30094071
pmcid: 6069906
Zadro J, O’Keeffe M, Maher C. Do physical therapists follow evidence-based guidelines when managing musculoskeletal conditions? Systematic review. BMJ Open. 2019;9(10):e032329. https://doi.org/10.1136/bmjopen-2019-032329 .
doi: 10.1136/bmjopen-2019-032329
pubmed: 31591090
pmcid: 6797428
Murad MH. Clinical practice guidelines: a primer on development and dissemination. Mayo Clin Proc. 2017;92(3):423–33. https://doi.org/10.1016/j.mayocp.2017.01.001 .
doi: 10.1016/j.mayocp.2017.01.001
pubmed: 28259229
Correa VC, Lugo-Agudelo LH, Aguirre-Acevedo DC, Contreras JAP, Borrero AMP, Patiño-Lugo DF, Valencia DAC. Individual, health system, and contextual barriers and facilitators for the implementation of clinical practice guidelines: a systematic metareview. Health Res Policy Syst. 2020;18(1):74. https://doi.org/10.1186/s12961-020-00588-8 .
doi: 10.1186/s12961-020-00588-8
pubmed: 32600417
pmcid: 7322919
Gleadhill C, Bolsewicz K, Davidson SRE, Kamper SJ, Tutty A, Robson E, Da Silva PV, Donald B, Dooley K, Manvell J, Manvell N, Delbridge A, Williams CM. Physiotherapists’ opinions, barriers, and enablers to providing evidence-based care: a mixed-methods study. BMC Health Serv Res. 2022;22(1):1382. https://doi.org/10.1186/s12913-022-08741-5 .
doi: 10.1186/s12913-022-08741-5
pubmed: 36411428
pmcid: 9677623
Cormican A, Hirani SP, McKeown E. Healthcare professionals’ perceived barriers and facilitators of implementing clinical practice guidelines for stroke rehabilitation: a systematic review. Clin Rehabil. 2023;37(5):701–12. https://doi.org/10.1177/02692155221141036.
Levenhagen K, Davies C, Perdomo M, Ryans K, Gilchrist L. Diagnosis of upper quadrant lymphedema secondary to cancer: clinical practice guideline from the Oncology Section of the American Physical Therapy Association. Phys Ther. 2017;97(7):729–45. https://doi.org/10.1093/ptj/pzx050 .
doi: 10.1093/ptj/pzx050
pubmed: 28838217
pmcid: 5803775
Davies C, Levenhagen K, Ryans K, Perdomo M, Gilchrist L. Interventions for breast cancer-related lymphedema: clinical practice guideline from the Academy of Oncologic Physical Therapy of APTA. Phys Ther. 2020;100(7):1163–79. https://doi.org/10.1093/ptj/pzaa087 .
doi: 10.1093/ptj/pzaa087
pubmed: 32589208
pmcid: 7412854
Davies C, Levenhagen K, Ryans K, Perdomo M, Gilchrist L. An executive summary of the clinical practice guideline: diagnosis of upper-quadrant lymphedema secondary to cancer. Rehabil Oncol. 2017;35(3):114–8. https://doi.org/10.1097/01.REO.0000000000000075 .
doi: 10.1097/01.REO.0000000000000075
Davies CC, Levenhagen K, Ryans K, Perdomo M, Gilchrist L. An executive summary of the APTA Academy for Oncologic Physical Therapy clinical practice guideline: interventions for breast cancer-related lymphedema. Rehabil Oncol. 2020;38(3):103–9. https://doi.org/10.1097/01.REO.0000000000000223 .
doi: 10.1097/01.REO.0000000000000223
Perdomo M, Ryans K, Levenhagen K, Davies CC, Gilchrist L. Clinical implementation of the clinical practice guidelines for diagnosing upper-quadrant lymphedema secondary to cancer. Rehabil Oncol. 2018;36(3):E11–8. https://doi.org/10.1097/01.REO.0000000000000115 .
doi: 10.1097/01.REO.0000000000000115
Ryans K, Perdomo M, Davies CC, Levenhagen K, Gilchrist L. Rehabilitation interventions for the management of breast cancer-related lymphedema: developing a patient-centered, evidence-based plan of care throughout survivorship. J Cancer Surviv. 2023;17(1):237–45. https://doi.org/10.1007/s11764-021-00991-2 .
doi: 10.1007/s11764-021-00991-2
pubmed: 33481161
Wampler M, Campione E, Bolch CA. Practice patterns of physical therapists and physical therapist assistants treating patients with breast cancer related lymphedema. Support Care Cancer. 2023;31(2):134. https://doi.org/10.1007/s00520-023-07589-7 .
doi: 10.1007/s00520-023-07589-7
pubmed: 36701027
Peters MAJ, Harmsen M, Laurant MGH, Wensing, M. Room for improvement? Barriers and facilitators for improvement of patient care. Centre for Quality of Care Research (WOK). Nijmegen: Radboud University Nijmegen Medical Centre; 2002.
R Core Team. R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna; 2021.
Williams B, Brown T, Onsman A. Exploratory factor analysis: a five-step guide for novices. Australas J Paramedicine. 2010;8(3):1–13. https://doi.org/10.33151/ajp.8.3.93.
Hair JF, Black WC, Babin BJ, Anderson RE. Multivariate data analysis. 7th ed. Pearson Education; 2014.
Horn JL. A rationale and test for the number of factors in factor analysis. Psychometrika. 1965;30(2):179–85. https://doi.org/10.1007/BF02289447 .
doi: 10.1007/BF02289447
pubmed: 14306381
Vedel I, Le Berre M, Sourial N, Arsenault-Lapierre G, Bergman H, Lapointe L. Shedding light on conditions for the successful passive dissemination of recommendations in primary care: a mixed methods study. Implement Sci. 2018;13(1):129. https://doi.org/10.1186/s13012-018-0822-x .
doi: 10.1186/s13012-018-0822-x
pubmed: 30326969
pmcid: 6192363
Brownson RC, Eyler AA, Harris JK, Moore JB, Tabak RG. Getting the word out: new approaches for disseminating public health science. J Public Health Manag Pract. 2018;24(2):102–11. https://doi.org/10.1097/PHH.0000000000000673 .
doi: 10.1097/PHH.0000000000000673
pubmed: 28885319
pmcid: 5794246
Sadeghi-Bazargani H, Tabrizi JS, Azami-Aghdash S. Barriers to evidence-based medicine: a systematic review. J Eval Clin Pract. 2014;20(6):793–802. https://doi.org/10.1111/jep.12222 .
doi: 10.1111/jep.12222
pubmed: 25130323
Sadoughi F, Azadi T, Azadi T. Barriers to using electronic evidence based literature in nursing practice: a systematised review. Health Info Libr J. 2017;34(3):187–99. https://doi.org/10.1111/hir.12186 .
doi: 10.1111/hir.12186
pubmed: 28726344
Graham ID, Logan J, Harrison MB, et al. Lost in knowledge translation: time for a map? J Contin Educ Health Prof. 2006;26(1):13–24. https://doi.org/10.1002/chp.47 .
doi: 10.1002/chp.47
pubmed: 16557505
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. https://doi.org/10.1186/1748-5908-4-50 .
doi: 10.1186/1748-5908-4-50
pubmed: 19664226
pmcid: 2736161
CFIR Research Team-Center for Clinical Management Research. Updated CFIR Constructs. Consolidated framework for implementation research. 2023. Accessed 14 Sept 2023. https://cfirguide.org/constructs/
Jun J, Kovner CT, Stimpfel AW. Barriers and facilitators of nurses’ use of clinical practice guidelines: an integrative review. Int J Nurs Stud. 2016;60:54–68. https://doi.org/10.1016/j.ijnurstu.2016.03.006 .
doi: 10.1016/j.ijnurstu.2016.03.006
pubmed: 27297368