Study suggests implementation of NICE guidance is patchy
Implementation of guidance issued by the National Institute for Clinical Excellence is patchy, the authors of new research conclude.
They assessed the response of the NHS to 12 pieces of NICE guidance and
found that some clinical practice subsequently changed. For example,
prescribing of taxanes for cancer and orlistat for obesity grew rapidly
after NICE guidance was published.
Uptake of drugs for Alzheimer’s disease and guidance for the removal
of wisdom teeth showed trends consistent with, but not obviously a consequence
of, the guidance. No change was apparent in surgical procedures and use
of medical devices, such as hearing aids, hip replacements, hernia repair
and
colorectal cancer surgery.The adoption of guidance seems more likely
when there is strong professional support, a stable and convincing evidence
base and adequate funding, say the authors. “Trusts should institute
strong supportive internal systems for handling guidance and gathering
data on implementation,” they conclude (BMJ 2004;329:999). |
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