Table 1 Details of included studies (n = 48)

Not reported

Nurse practitioners, physician’s assistant, physician

Initiation of a recommended therapeutic alternative within 90 days of the fax alert for the 13 PDDIs

Prescribing Behaviors

Faxed alerts

N

N

N

Therapy change

na^d

Primary Care

Doctors

Prescribing errors

Prescribing Behaviors

Computer-generated feedback

Y

Y

Y

Prescription problems

0.09^b

S

Prescribed B Blocker

0.08^b

S

Prescribed an NSAID

0.17^b

S

Dentist

Dental practitioners

Guideline implementation for the management of impacted and un-erupted third molars in primary dental care

Adherence to clinical patient management guidelines

Computer-based training

Y

Y

N

Guideline implemented

-0.10^b

S

Community Care

Mental health community therapists

Therapist adherence to CBT for child anxiety, skill in CBT for child anxiety, knowledge about CBT for child anxiety, and satisfaction with training.

Adherence to clinical patient management guidelines

Computer-based training

Y

Y

N

Guideline adherence

-0.15^b

S

Nursing Home

Nurses, nursing assistants, physiotherapists, occupational therapists

Adherence to recommendations to pressure ulcer prevention

Adherence to clinical patient management guidelines

Healthcare professional decision supports

Y

Y

Y

Guideline adherence

1.26^b

L

Tertiary Care

Doctors (senior and junior)

Antibiotic prescribing

Prescribing Behaviors

Healthcare professional decision supports

N

N

Y

Concordant therapy

0.76^b

M

Hospital

Junior and senior practitioners

Effects of computer-based guidelines on unnecessary medical imaging

Adherence to clinical patient management guidelines

Reminders/ alerts

N

N

Y

Test requests not confirming to guidelines

0.17^b

S

Tertiary Care

Clinicians

Inappropriate antimicrobial therapy

Adherence to clinical patient management guidelines

Text message

N

N

N

Guideline adherence

0.19^b

S

Primary Care & Secondary Care

Physicians

To increase bone mineral density (BMD) testing and osteoporosis medication prescribing among patients receiving long term glucocorticoid therapy

Adherence to clinical patient management guidelines & Prescribing Behaviors

Hyperlinks

Y

Y

N

na^d

Secondary Care

Mental health treatment providers

Increasing knowledge and self-efficacy and application of course content performance-based role plays

Increasing knowledge, or self-efficacy/confidence

Computer-based training

Y

Y

Y

Knowledge

0.52^c

M

Hospital

Nurses, resident physicians, physical therapists, pharmacist, and dieticians

Adherence to practice guidelines for heart failure

Adherence to clinical patient management guidelines

Healthcare professional decision supports

N

Y

Y

na^d

Primary Care

GPs and practice nurses

Adherence to the guidelines

Adherence to clinical patient management guidelines

Healthcare professional decision supports

Y

Y

N

Blood pressure recorded

0.00^b

S

Exercise recorded or advised

-0.16^b

S

Weight recorded or advised

-0.11^b

S

Smoking status known

-0.28^b

S

Smoking education given

0.00^b

S

electrocardiogram recorded

0.00^b

S

Exercise electrocardiogra m recorded

0.00^b

S

Haemoglobin concentration recorded

0.00^b

S

Thyroid function recorded

-0.10^b

S

Cholesterol or other lipid concentrations recorded

-0.09^b

S

Blood glucose or HBA_1c concentrations recorded

0.00^b

S

Primary Care

Physicians

Confidence and knowledge

Increasing knowledge, or self-efficacy/confidence

Healthcare professional decision supports

N

N

Y

Confidence discussing sickle cell disease

Confidence conducting follow-up

na^d

Hospital

Clinical staff

Identification of psychiatric problems/ hospital assessments

Increasing screening/testing rates

Healthcare professional decision supports

N

N

Y

Identification of adolescents with psychiatric problems

0.29^b

S

ED assessments

0.22^b

S

Hospital

Primary care physicians

Improving both practitioner adherence to National Asthma Education and Prevention Program Guidelines (NAEPP)

Adherence to clinical patient management guidelines

Reminders/ alerts

Computer-generated feedback

N

Y

Y

Guideline appropriate prescribing

na^d

Primary Care

GPs

Increasing the use of antiplatelet drugs for diabetic patients at high-risk to develop future CVD

Prescribing Behaviors

Healthcare professional decision supports

Y

Y

Y

Patients treated

0.36^b

S

Hospital

Physicians, nurse practitioners and physician assistants

Reducing prescribing of heavily marketed hypnotic medications in ambulatory care settings

Prescribing Behaviors

Reminders/ alerts

Y

Y

Y

na^d

Primary Care

Paediatricians

Decrease inappropriate antibiotic prescribing for common ARTIs over time by primary care paediatricians

Prescribing Behaviors

Email Feedback

Y

Y

Y

na^d

Primary Care

Primary care clinicians

Increasing the rate of risk-based and routine HIV diagnostic tests

Increasing screening/testing rates

Reminders/ alerts

Y

Y

Y

na^d

Primary Care & Secondary Care

Academic and non-academic staff physicians, postgraduate medical trainees and mid-level providers

Increasing the rate of HIV diagnostic testing

Increasing screening/testing rates

Reminders/ alerts

Email Feedback

N

Y

Y

na^d

Primary Care

Clinicians

Antibiotic treatment of uncomplicated acute bronchitis

Prescribing Behaviors

Healthcare professional decision supports

Y

Y

Y

Unnecessary use of antibiotics

0.46^b

S

Primary Care

GPs

Initiation of treatment

Clinical intervention/ management

Electronic Feedback System

Y

Y

Y

Oral antidiabetic treatment initiated (1)

0.71^b

M

Oral antidiabetic treatment initiated (2)

0.71^b

M

Insulin treatment initiated (1)

0.55^b

M

Insulin treatment initiated (2)

0.37^b

S

Lipid lowering treatment initiated

0.71^b

M

Blood-pressure reducing treatment initiated

0.90^b

L

Hospital

Physicians

Appropriate head CT use in patients with mild traumatic brain injury guideline adherence

Adherence to clinical patient management guidelines

Healthcare professional decision supports

N

N

Y

na^d

Hospital

Clinicians

Blood transfusion practice of clinicians

Increasing screening/testing rates

Healthcare professional decision supports

N

Y

Y

Transfusion compliance

0.46^b

S

Primary Care

Primary care practitioners

Prescribing of lipid lowering agents, use of lab tests, and referrals to secondary care for the investigation of hyperlipidaemia

Prescribing Behaviors & Increasing appropriate referrals

Healthcare professional decision supports

Y

Y

N

na^d

Primary Care

Physicians

Imitating potassium testing

Increasing screening/testing rates

Reminders/ alerts

N

N

Y

na^d

Primary Care

Physicians

nurses physiotherapists

ward nurses

a psychologist

Reminders for best practice guidelines/recommendations

Adherence to clinical patient management guidelines

Healthcare professional decision supports

Y

Y

N

na^d

Primary Care

Physicians, nurse practitioners, physician’s assistants

Prescribing behavior - antibiotic prescribing for acute respiratory infections

Prescribing Behaviors

Healthcare professional decision supports

N

N

Y

na^d

Primary Care

Primary care clinicians: family physicians, general internist, nurse practitioners, physician’s assistants, and family medicine residents

Rate of compliance with guideline recommendations for diabetes patient care

Adherence to clinical patient management guidelines

Healthcare professional decision supports

Y

Y

Y

Foot examination

0.62^b

M

Complete physical examination

1.07^b

L

Chronic glycemia monitoring

0.10^b

S

Urine protein determination

2.36^b

L

Cholesterol level

0.89^b

L

Ophthalmologic examination

1.09^b

L

Influenza vaccination

0.18^b

S

Primary Care

GP trainees

Improving knowledge and practice behavior

Increasing knowledge, or self-efficacy/confidence & Clinical intervention/ management

Computer-based training

N

Y

Y

knowledge test

0.44^c

S

correct performance in visit

1.59^c

L

Pharmacy

Prescribers

Prevention of serious drug-drug interactions (DDI) prescribing patterns of 25 previously identified clinically important potential DDIs

Prescribing Behaviors

Personal Digital Assistant

N

Y

N

Prescribing at least one DDI

0.20^b

S

Hospital

Physician

Nurse practitioner

Captured opportunities for HPV vaccination

Increasing screening/testing rates

Reminder within patient electronic health records

Y

Y

Y

na^d

Secondary Care

Physicians

Physician compliance with diabetes preventive care guidelines

Adherence to clinical patient management guidelines

Reminders/ alerts

Y

Y

N

na^d

Hospital

Breast clinicians (surgeons)

Adherence to guideline recommendations

Adherence to clinical patient management guidelines

Healthcare professional decision supports

Y

Y

Y

adherence to guidelines

1.03^b

L

Hospital

Ophthalmologists and hospital pharmacists

Uptake of drug safety information

Adherence to clinical patient management guidelines

Email Feedback

Y

Y

Y

correctly indicated that a serious increase in intra-ocular pressure could be caused by pegaptanib injections

0.86^b

L

Pharmacy

Pharmacists

Frequency of clinical interventions recorded by community pharmacists/to discuss the suitability of aspirin therapy in eligible patients with diabetes

Clinical intervention/ management & Prescribing Behaviors

Healthcare professional decision supports

Y

Y

Y

na^d

Hospital

Doctor, nurse, pharmacist

To promote spontaneous adverse drug reaction reporting by healthcare professionals

Prescribing Behaviors

Hyperlinks

N

N

Y

na^d

Tertiary care

Clinicians - staff physicians, physician assistants, nurse practitioners

Practice patterns and consequently improve the detection and management of nosocomial infections.

Clinical intervention/ management

Reminders/ alerts

N

N

N

Patient management recommendations followed

Hospital

Nurses

Clinicians eliciting and integrating patients’ preferences into patient care

Clinical intervention/ management

Diagnostic/ risk assessment tool

N

Y

Y

congruence between patient preferences and nurse care priorities

0.67^c

M

Primary Care

Primary care providers

Provision of family planning services when prescribing potentially teratogenic medications

Clinical intervention/ management

Healthcare professional decision supports

Y

Y

Y

discussion of risk of medication use

0.70^c

M

Primary Care

Physicians

Tobacco smoke exposure management and quit-line referrals

Increasing appropriate referrals

Reminder within patient electronic health records

N

N

Y

counselling for positive screen

1.36^b

L

Primary Care

Physicians

Smoking cessation counselling behaviors, knowledge and comfort/self-efficacy

Increasing knowledge, or self-efficacy/confidence & Clinical intervention/ management

Personal Digital Assistant

N

N

Y

na^d

Hospital

Resident physicians and nurse practitioners

Changing prescribing reduce concomitant orders for warfarin and trimethoprim-sulfamethoxazole,

Prescribing Behaviors

Reminders/ alerts

Y

Y

N

na^e

Secondary Care

Clinicians

Influenza vaccination by clinicians Compliance with the guideline: was defined as documentation that a clinician ordered the vaccine, counselled the patient about the vaccine, offered the vaccine to a patient who declined it, or verified that the patient had received the vaccine elsewhere

Adherence to clinical patient management guidelines

Healthcare professional decision supports

N

N

Y

compliance with guidelines

0.88^b

L

Primary Care

Physicians and pharmacists

Management of heart disease adherence with care suggestions

Adherence to clinical patient management guidelines

Healthcare professional decision supports

Y

Y

N

Compliance with guidelines

0.04^b

S

Primary Care

Family physicians

Prescribing - prescription of antihypertensive and lipid-lowering medication.

Prescribing Behaviors

Diagnostic/ risk assessment tool

Y

Y

N

Prescribing of antihypertensive

Prescribing of lipid-lowering medication

-0.21^b

S

Primary Care

GPs

Screening and treatment for dyslipidaemia

Increasing screening/testing rates

Reminders/ alerts

Y

Y

Y

patients screened

0.93^b

L

patient treated

0.68^b

M

Primary Care

GPs

Increasing opportunistic chlamydia testing

Increasing screening/testing rates

Reminders/ alerts

Y

Y

N

Testing rates

-0.09^b

S