SynthesisJournal of evaluation in clinical practice2025
Barriers and facilitators of adherence to clinical practice guidelines in Germany-A systematic review.
Synthesis in Journal of evaluation in clinical practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Nutrition Recommendations for People Living After Cancer: A Systematic Review and Critical Appraisal of Clinical Practice Guidelines.Nutrients · 2026Pooled it
- Barriers and facilitators of adherence to clinical practice guidelines in Germany-A systematic review.Journal of evaluation in clinical practice · 2025Pooled it
- Article
- Implementing Clinical Practice Guidelines for Oral Care for (Frail) Older Patients: Facilitators, Barriers, and Recommendations.Gerodontology · 2026Article
- Guideline adherence for the management of cardiovascular disease in primary care: a scoping review.Family practice · 2026Article
- From global guidelines for cardio-kidney-metabolic diseases management to national implementation: perspectives from the guideline workshop taskforce.Cardiovascular diabetology · 2026Article
- Antibiotic Use in Pediatrics: Perceptions and Practices of Romanian Physicians.Antibiotics (Basel, Switzerland) · 2025Article
- Methods and reporting of studies assessing the impact of adherence to clinical practice guidelines: a scoping review.BMC medicine · 2025Article
- Awareness of adapting clinical practice guidelines to a local context.Clinical and public health guidelines · 2025Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
rationaleClinical Practice Guidelines (CPGs) represent evidence-based tools designed to assist healthcare practitioners and patients in decisions in clinical practice. Evidence supports the clinical benefits of adhering to CPGs. However, their successful implementation and adherence in clinical settings often encounter challenges. AIMS AND
objectivesThis systematic review aimed to explore barriers and facilitators influencing adherence to CPGs in Germany.
methodThe protocol of this study was registered in the Open Science Framework (OSF) registry (DOI: 10.17605/OSF. IO/GMFUB). In November 2022 we searched on PubMed and Embase for primary studies employing qualitative, quantitative and mixed-methods approaches that focus on barriers or facilitators to CPGs adherence in the Germany. Two reviewers independently screened articles, extracted data, and evaluated the quality of the studies. The collected data on barriers and facilitators of CPG adherence were systematically categorized and analyzed using the Theoretical Domains Framework (TDF).
resultsA total of 24 studies were included, mainly focusing on adherence to national CPGs. This review introduces a new domain, guideline characteristics, reflecting the need to address barriers and facilitators to CPG development, implementation, dissemination and format, which couldn't be encompassed within the existing 14 domains of TDF framework. Among healthcare professionals, the most frequently reported influencing factors were related to the environmental context and resources (encompassing aspects such as employer support for CPG utilization), the CPG development and dissemination process (including layout, wording, and interactive tools) and beliefs about consequences (such as contradictions with practical experience). Knowledge (knowledge about the content of CPGs, awareness about published CPGs), primarily as a barrier, and reinforcement facilitators (notably financial support), were also frequently reported.
conclusionThe findings revealed multilevel factors contributing to CPG adherence, with environmental context and resources emerging as the most frequently reported considerations. This systematic review offer holistic insights into the barriers and facilitators of CPG adherence in Germany. The results contribute to a better understanding of the topic and serve as a resource for developing targeted strategies to enhance CPG adherence and implementation within the German healthcare system.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.