Cochrane · systematic review · CD009780
Implementation of treatment guidelines for specialist mental health care
Bighelli, I, Ostuzzi, G, Girlanda, F, et al. · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
15
current version
GRADE rated
9
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 6 · 40%Very low 6 · 40%Low 3 · 20%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyActive education + Support for implementation compared with Routine care or Passive dissemination for participants with schizophrenia and related psychosis
Population: participants with schizophrenia and related psychosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Process outcome, Practitioner Impact 1. Polypharmacy at Active education + Support for implementation vs Routine care or Passive dissemination | RR 0.97 [0.75, 1.25] | 2 studies · 310 participants | Very low Downgraded: risk of bias, imprecision |
Process outcome, Practitioner Impact: 2. Not screened for cardiovascular risk, Framingham score (corrected for design effect) Active education + Support for implementation vs Routine care or Passive dissemination | RR 0.71 [0.48, 1.03] | 1 study · 38 participants | Very low Downgraded: risk of bias, imprecision |
Patient outcome: Global state: average score (PANSS total, high = poor) Active education + Support for implementation vs Routine care or Passive dissemination | no estimate extracted | 1 study · 59 participants | Very low Downgraded: risk of bias, imprecision |
Patient outcome: satisfaction with care: average score (ZUF8, high = better satisfaction) Active education + Support for implementation vs Routine care or Passive dissemination | no estimate extracted | 1 study · 46 participants | Very low Downgraded: risk of bias, imprecision |
Patient outcome: treatment adherence: not adherent at Active education + Support for implementation vs Routine care or Passive dissemination | RR 0.9 [0.44, 1.85] | 1 study · 52 participants | Very low Downgraded: risk of bias, imprecision |
Patient outcome: drug attitude: average score (DAI, high = positive attitude) Active education + Support for implementation vs Routine care or Passive dissemination | no estimate extracted | 1 study · 32 participants | Very low Downgraded: risk of bias, imprecision |
Patient outcome: quality of life Active education + Support for implementation vs Routine care or Passive dissemination | no estimate extracted | 0 studies · 0 participants | Ungraded |
Re‐written guideline text compared to original guideline text for patients with schizophrenia and related psychosis
Population: patients with schizophrenia and related psychosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Process outcome, Practitioner Impact 3. Staff not trained (as suggested by the guideline) Re‐written guideline text vs original guideline text | RR 1.03 [0.87, 1.21] | 1 study · 68 participants | Low Downgraded: imprecision |
Process outcome, Practitioner Impact 4. Staff not supervised (as suggested by the guideline) Re‐written guideline text vs original guideline text | RR 0.86 [0.64, 1.17] | 1 study · 68 participants | Low Downgraded: imprecision |
Process outcome, Practitioner Impact 5. Staff did not provide psychological interventions (as suggested by the guideline) Re‐written guideline text vs original guideline text | RR 0.86 [0.62, 1.18] | 1 study · 68 participants | Low Downgraded: imprecision |
Patient outcome: Global state Re‐written guideline text vs original guideline text | no estimate extracted | 0 studies · 0 participants | Ungraded |
Patient outcome: Satisfaction with care Re‐written guideline text vs original guideline text | no estimate extracted | 0 studies · 0 participants | Ungraded |
Patient outcome: Treatment adherence Re‐written guideline text vs original guideline text | no estimate extracted | 0 studies · 0 participants | Ungraded |
Patient outcome: Drug attitude Re‐written guideline text vs original guideline text | no estimate extracted | 0 studies · 0 participants | Ungraded |
Patient outcome: Quality of life Re‐written guideline text vs original guideline text | no estimate extracted | 0 studies · 0 participants | Ungraded |
Active education + Support for implementation compared with Routine care or Passive dissemination for participants with schizophrenia and related psychosis
Population: participants with schizophrenia and related psychosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Polypharmacy at Active education + Support for implementation vs Routine care or Passive dissemination | RR 0.97 [0.75, 1.25] | 310 participants | Very low Downgraded: risk of bias, imprecision |
Not screened for cardiovascular risk factors Active education + Support for implementation vs Routine care or Passive dissemination | RR 0.71 [0.48, 1.03] | 38 participants | Very low Downgraded: risk of bias, imprecision |
Global state—PANSS total score Active education + Support for implementation vs Routine care or Passive dissemination | no estimate extracted | 59 participants | Very low Downgraded: risk of bias, imprecision |
Satisfaction with care—ZUF8 Active education + Support for implementation vs Routine care or Passive dissemination | no estimate extracted | 46 participants | Very low Downgraded: risk of bias, imprecision |
Lack of treatment adherence—design effect corrected Active education + Support for implementation vs Routine care or Passive dissemination | RR 0.9 [0.44, 1.85] | 52 participants | Very low Downgraded: risk of bias, imprecision |
Drug attitude—DAI Active education + Support for implementation vs Routine care or Passive dissemination | no estimate extracted | 32 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life Active education + Support for implementation vs Routine care or Passive dissemination | no estimate extracted | 0 studies · 0 participants | Ungraded |