Effective strategies for scaling up evidence-based practices in primary care: a systematic review

In 2017, the article Effective strategies for scaling up evidence-based practices in primary care: a systematic review was published. France Légaré, Scientific Director of the Université Laval branch of the Change Management axis of our unit, is a member of the writing team.

Context

A wide range of evidence-based practices have the potential to improve patient outcomes, but little is known about how to implement them at scale. This study aimed to identify effective strategies for scaling up evidence-based practices in primary care.

Methods

The authors conducted a systematic review of randomized controlled trials and observational studies involving primary care units where interventions aimed at scaling up evidence-based practices were implemented. Searches covered multiple databases and grey literature sources. Effective scaling strategies were extracted and grouped into categories.

Results

The study included 14 publications, mostly conducted in low- or middle-income countries and funded by governmental agencies. The targeted diseases were primarily infectious. The review identified five major components of scaling strategies:

Conclusion

Few evaluations of scaling strategies were identified. Their effectiveness remains uncertain, as studies focused mainly on clinical outcomes rather than the scaling process itself. A minimal consensus on scaling indicators is needed to better assess its impact in these contexts.