Clinical practice guideline implementation: challenges and solutions for improved cardiovascular care: A Report from the European Society of Cardiology Cardiovascular RoundTable

The European Society of Cardiology (ESC) develops and updates clinical practice guidelines (CPGs) based on the latest evidence. However, their implementation remains suboptimal, leading to missed opportunities to improve cardiovascular (CV) outcomes. The success of CPG implementation is influenced by four key factors: (1) patient-related barriers, (2) health care professionals' engagement, (3) the clarity and usability of CPGs, and (4) the health care system and economic context in which care is delivered. To address these challenges, innovative strategies are needed to bridge the gap between CPG recommendations and clinical practice. The ESC has developed several initiatives to improve implementation, including (1) educational programmes, (2) examinations for cardiologists, (3) accreditation policies, and (4) registries. However, persistent gaps indicate that knowledge dissemination alone is insufficient. A more integrated, structured, and equitable approach to quality-of-care improvement is required. Despite the need for evidence-based implementation strategies, only a limited number of high-quality randomised controlled trials (RCTs) have evaluated individual approaches for CV conditions. Strategies such as text messaging, educational interventions, the involvement of non-physician health workers, structured order sheets, and financial incentives have been tested, but their feasibility and effectiveness can vary across health care systems. Future research should explore the potential of artificial intelligence (AI)-enhanced technologies to support and scale implementation efforts. This manuscript reviews current evidence on CPG implementation and proposes strategies to enhance the adoption of best practices in CV care.

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Publication Details

Journal
European Heart Journal - Quality of Care and Clinical Outcomes
Published
2026-01-29
DOI
https://doi.org/10.1093/ehjqcco/qcaf161
Citations
2
Primary Topic
Clinical practice guidelines implementation
Type
article
Field-Weighted Citation Impact
83.69
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article

Clinical practice guideline implementation: challenges and solutions for improved cardiovascular care: A Report from the European Society of Cardiology Cardiovascular RoundTable

Suleman Aktaa, Laney K. Jones, Anne Chevrier, Amr M. Abdin et al.
2 citations
European Heart Journal - Quality of Care and Clinical Outcomes
Clinical practice guidelines implementation
83.69
article

Clinical practice guideline implementation: challenges and solutions for improved cardiovascular care: A Report from the European Society of Cardiology Cardiovascular RoundTable

Suleman Aktaa, Laney K. Jones, Anne Chevrier, Amr M. Abdin, Chris Plummer, Mark Minchin, Izabella Uchmanowicz, Tuula Rintala, G. Hindricks, Julie Sanders, Nico Bruining, F Tanner, Ricardo Rocha, Alexandra G. Gonçalves, Panos E. Vardas, Eva Irene Bosano Prescott, Alar Irs, Alphons Vincent, Harriette G C van Spall, Salim Yusuf, Stefan James, Tamara Krcmar, Richard Mindham, F W Asselbergs, C P Gale, J W Mcevoy, Isabelle Van Gelder, Thomas F Lüscher
article en
2 citations

Abstract

The European Society of Cardiology (ESC) develops and updates clinical practice guidelines (CPGs) based on the latest evidence. However, their implementation remains suboptimal, leading to missed opportunities to improve cardiovascular (CV) outcomes. The success of CPG implementation is influenced by four key factors: (1) patient-related barriers, (2) health care professionals' engagement, (3) the clarity and usability of CPGs, and (4) the health care system and economic context in which care is delivered. To address these challenges, innovative strategies are needed to bridge the gap between CPG recommendations and clinical practice. The ESC has developed several initiatives to improve implementation, including (1) educational programmes, (2) examinations for cardiologists, (3) accreditation policies, and (4) registries. However, persistent gaps indicate that knowledge dissemination alone is insufficient. A more integrated, structured, and equitable approach to quality-of-care improvement is required. Despite the need for evidence-based implementation strategies, only a limited number of high-quality randomised controlled trials (RCTs) have evaluated individual approaches for CV conditions. Strategies such as text messaging, educational interventions, the involvement of non-physician health workers, structured order sheets, and financial incentives have been tested, but their feasibility and effectiveness can vary across health care systems. Future research should explore the potential of artificial intelligence (AI)-enhanced technologies to support and scale implementation efforts. This manuscript reviews current evidence on CPG implementation and proposes strategies to enhance the adoption of best practices in CV care.

European Heart Journal - Quality of Care and Clinical Outcomes
Uppsala University (SE), St Bartholomew's Hospital (GB), University of Leeds (GB), Amgen (United States) (US), State Space Agency of Ukraine (UA), University Medical Center Groningen (NL), Uppsala University Hospital (SE), University of Crete (GR), Bristol-Myers Squibb (Germany) (DE), King's College - North Carolina (US), Universidade do Porto (PT), King's College London (GB), Ollscoil na Gaillimhe – University of Galway (IE), University of Zurich (CH), Academy of Athens (GR), Barts Health NHS Trust (GB), Edinburgh Napier University (GB), Leeds Teaching Hospitals NHS Trust (GB), Frederiksberg Hospital (DK), St. Paul's Hospital (CA), Newcastle upon Tyne Hospitals NHS Foundation Trust (GB), Bispebjerg Hospital (DK), Tartu University Hospital (EE), University Hospital Galway (IE), Harefield Hospital (GB), Population Health Research Institute (CA), Medtronic (Ireland) (IE), National Institute for Health and Care Excellence (GB), National Institute for Health and Care Research (GB), Wroclaw Medical University (PL), University of Belgrade (RS), Advocate Health Care (US), Santé Publique France (FR), Biomedical Research Foundation of the Academy of Athens (GR), Royal Brompton Hospital (GB), University Hospital of Zurich (CH), Lung Institute (US), Amsterdam Neuroscience (NL), Leipzig Heart Institute (DE), Intellia Therapeutics (United States) (US), University Clinical Centre (PL), NIHR Newcastle Biomedical Research Centre (GB), Servier (France) (FR), COPE Galway (IE), Austrian Competence Centre of Food Safety (AT), Deutsches Herzzentrum München (DE), Fondation Sophia Antipolis (FR), Amsterdam University Medical Centers (NL), Berlin Heart (Germany) (DE), University College London (GB), Hamilton Health Sciences (CA), University of Amsterdam (NL), Erasmus University Rotterdam (NL), Saarland University (DE), McMaster University (CA)
Openalex Percentile: Top 0%
Clinical practice guidelines implementation
83.69
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