Evidence-based clinical practice guidelines are statements that provide recommendations to optimize patient care for a specific clinical problem or question. However, the mere act of reading a guideline rarely leads to implementation of recommendations, and active dissemination is required. The American Academy of Neurology (AAN) has a formal process of guideline development and dissemination to physicians and patients. The role of social media (face book, twitter, etc.) and newer methods of dissemination (podcasts, webinars etc.) in guideline dissemination has not been studied. The AAN is currently developing an evidence- based guideline entitled "Complementary and Alternative Medicine (CAM) in multiple sclerosis (MS)" to make recommendations regarding the safety and efficacy of CAM in MS. This topic is very important because CAM is frequently used by MS patients, who seldom discuss their use of CAM with their physicians. Objectives:
Specific Aim 1 : To institute a new, innovative dissemination strategy combining traditional (presently used methods) and newer methods for the guideline entitled "CAM in MS".
Specific Aim 2 : To measure the effectiveness of the dissemination strategy by process and outcome measures.
Specific Aim 3 : To compare the effectiveness of different methods of dissemination in different target audiences in order to evaluate the best methods of dissemination for each audience. This proposal addresses two AHRQ portfolios of research: patient safety and innovations/emerging issues, and the AHRQ priority population of individuals with special health care needs. It is in keeping with PCORI's research questions: to assess the benefits of health delivery system interventions and to address individual differences and barriers to implementation and dissemination. Methods: The dissemination plan will include a pre- dissemination survey to define the problem and identify the audience, gaps in care, implementation barriers, and dissemination opportunities. The dissemination strategy will utilize both traditional and non-traditional, innovative methods. Having disseminated the guideline, the effectiveness of the strategy will be evaluated using process measures: how many patients and physicians did the guideline reach? and outcome measures: change in practice patterns: i.e., did physicians start asking patients regularly about CAM use? Did patients make changes in CAM use? Finally, the process and outcome measures will be evaluated for each dissemination method, and for each target audience. Conclusion: The results of this study have strong implications for future dissemination efforts for evidence based guidelines in general by identifying effective dissemination methods that utilize resources efficiently and effectively. Lessons learned from this project will influenc the development of models for guideline dissemination methods in general.

Public Health Relevance

The dissemination of the evidence based guideline, Complementary and Alternative Medicine (CAM) in Multiple Sclerosis (MS) will inform the public, patients with MS and physicians about the safety and effectiveness of CAM in MS. This is important to make informed decisions about the use of CAM by patients with MS. On a larger scale, this study evaluates several new dissemination tools such as social media to determine if specific target audiences access information through specific dissemination tools preferentially. This will streamline the dissemination of future guidelines in the most effective and efficient manner to reach a large audience.

National Institute of Health (NIH)
Agency for Healthcare Research and Quality (AHRQ)
Research Demonstration and Dissemination Projects (R18)
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Special Emphasis Panel (ZHS1-HSR-X (03))
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Hsia, David
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American Academy of Neurology
United States
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