TY - GEN A1 - Pieper, Dawid A1 - Pachanov, Alexander A1 - Bahns, Carolin A1 - Prill, Robert A1 - Kopkow, Christian A1 - Shehu, Eni A1 - Song, Yang A1 - Amer, Yasser Sami A1 - Stein, Airton Tetelbom A1 - Choi, Kyung-Eun Anna T1 - Locally adapted guidelines: a scoping review T2 - Systematic Reviews N2 - Background Clinical practice guidelines (CPGs) often fail to be fully implemented in practice. One barrier to CPG implementation is inconsistency between recommendations and existing practice patterns. This can include patients, personnel, structure, availability of resources, cultural and ethical values. To account for this, it is feasible to tailor national CPGs to a regional or local context (e.g. hospital). Local ownership can be beneficial and help to implement the guideline without affecting guideline validity. This process is also known as guideline adaptation. We aimed to identify randomized controlled trials (RCTs) investigating the effectiveness of locally adapted CPGs. Methods We performed a scoping review, following the JBI guidance. The scoping review was registered with the Open Science Framework (https://osf.io/3ed2w). The intervention had to be a locally adapted guideline (locally meaning adapted to any delineated area and/or entity at subnational and/or transnational level). Co-interventions were accepted. We did not restrict the control group. As we considered locally adapted guidelines as an intervention, and it seems feasible to test locally adapted guidelines in trials, we only considered RCTs, including cluster-RCTs. PubMed and Embase were searched in November 2024. Two reviewers independently screened titles and abstracts, full-text articles, and charted data. Conflicts were resolved by involving a third reviewer. Data were summarized descriptively. The findings were discussed with knowledge users. Results Five cluster RCTs reported in 8 publications and published between 2000 and 2010, were included. The trials originated from the UK, Scotland, Australia, the US, and the Netherlands. The adapted CPGs focused on diabetes, asthma, smoking cessation, mental disorders, and menorrhagia and urinary incontinence. The number of sites (e.g. practices) ranged from 4 to 30. Reporting was mostly insufficient to understand how adaptation was performed. Interventions always included some form of dissemination, such as educational meetings or workshops. Conclusions There is a lack of RCTs investigating the effectiveness of locally adapted guidelines. A systematic review is unwarranted due to the clinical and methodological heterogeneity of these trials. The identified studies were largely conducted over 20 years ago, highlighting a significant knowledge gap. The reasons for the lack of similar studies today are unclear, which is surprising given advances in adaptation frameworks in guideline development. As the importance of contextualization is emphasized, future studies on locally adapted guidelines should be conducted with strong rationale supported by local data. Without a sound rationale, there is a risk that evidence-based, high-quality guidelines could be undermined. In future trials, authors should closely adhere to reporting guidelines. Systematic review registration https://osf.io/3ed2w. KW - Leitlinien KW - Guideline KW - Scoping Review Y1 - 2025 U6 - https://doi.org/10.1186/s13643-025-02808-0 SN - 2046-4053 VL - 14 IS - 1 SP - 1 EP - 9 PB - Springer Science and Business Media LLC ER - TY - GEN A1 - Pieper, Dawid A1 - Behnke, Eva‐Maria A1 - Dumke, Rieke A1 - Kehr‐Fuckel, Christel A1 - Radow, Carolin A1 - Schulze, Nils A1 - Follmann, Markus A1 - Schaefer, Corinna A1 - Prill, Robert A1 - Kopkow, Christian A1 - Bahns, Carolin A1 - Choi, Kyung‐Eun (Anna) A1 - Fischer, Lena T1 - Awareness of adapting clinical practice guidelines to a local context T2 - Clinical and public health guidelines N2 - Background Guideline recommendations are often not implemented in practice. This can be attributed to factors such as patient preferences and characteristics, structural conditions, personnel or other resources, as well as cultural or ethical aspects. Adaptations to the local context (e.g., regional or hospital) result in so-called locally adapted guidelines (LAGL), which could improve implementation. We aimed to assess the awareness of LAGL among guideline developers in Germany. Methods An online survey was conducted via LimeSurvey in May 2024. The questionnaire, designed based on literature and expert opinions, consisted of 23 items, predominantly with dichotomous response options. Recruitment was conducted via email. Direct contact addresses were identified using the German guideline registry (n = 397). Additionally, a mailing list distribution was conducted through the guidelines working group of the German Network for Evidence-Based Medicine (n = 316). Only fully completed questionnaires were included in the analysis. Data cleaning and descriptive analysis were performed using Excel. Results A total of 63 questionnaires were fully completed. The most represented groups were physicians (65%) and methodologists (24%), most frequently in coordination (76%) or as group members (62%). The most judicious reasons for developing a LAGL were differences in patient populations (48%), currency of recommendations (46%), and patient values and preferences (44%). The most commonly cited likely reasons for developing a LAGL were economic considerations (32%), differences in patient populations (30%), and currency of recommendations (30%). Many respondents (59%) were aware of the possibility of adapting existing guidelines to the local context. Among these, approximately half (49%) had already locally adapted a guideline, with 75% using an adaptation framework. Discussion LAGLs are known among guideline developers in Germany and are generally developed using adaptation frameworks. Potential reasons for preparing LAGLs are diverse, with some discrepancies between perceived valid and likely reasons. Highlights Over half (59%) of surveyed clinical practice guideline (CPG) developers in Germany were aware of the possibility of adapting CPGs to local contexts, and nearly half of them had practical experience doing so. Although several adaptation frameworks exist, only 44% of experienced adaptors were familiar with them, and among users, many found them only partly helpful. Differences in patient populations, outdated recommendations, and patient values were rated as the most valid reasons for local CPG adaptation, while economic factors were seen as the most likely driver in practice. Despite existing awareness, guideline adaptation to local settings remains underutilized and lacks structured implementation, highlighting the need for clearer definitions, better resources, and more practical examples. KW - Leitlinien Y1 - 2025 U6 - https://doi.org/10.1002/gin2.70025 SN - 2836-3973 VL - 2 IS - 3 SP - 1 EP - 7 PB - Wiley CY - Hobken, New Jersey ER -