The Impact of Scottish Intercollegiate Guidelines Network within General Practice in Scotland: A Scoping Review

Abstract

The Scottish Intercollegiate Guidelines Network (SIGN) is a network of academic and clinical experts who focus on developing up-to-date and evidence-based guidelines to inform Scotland's clinical practice. SIGN guidelines provide broad coverage of recommendations for all clinical specialties and those pertinent to the nursing, pharmacy, dentistry, and allied health professions. SIGN has 41 clinical guidelines published and freely accessible to all health professionals. Healthcare practitioners use clinical guidelines to make decisions on care and treatment. Evidence indicates that the adoption of clinical guidelines can improve quality of patient care. To explore the effectiveness of SIGN guidelines on patient outcomes in a general practice setting in Scotland. In response to uncertainty regarding the effectiveness of patients' guidelines, this scoping review aimed to address this important knowledge gap through the evaluation of the relevant evidence presented in the literature. This scoping review was carried out using systematic approaches to finding the studies and analysing them following PRISMA-ScR checklist. Tools such as CASP were applied to optimize the ability to generate credible and informative evidence for SIGN guideline developers and primary care practice within Scotland. A search for literature was conducted between 27th of September and 12th of October 2020 using the databases of MEDLINE and EMBASE and relevant search terms. Articles were restricted to English language, peer-review and publication in the past 20 years. The search results yielded over seven hundred studies that were screened and analysed for eligibility before being included. Nine studies in total were found to meet the criteria for inclusion. With conflicting evidence regarding the impact of SIGN guidelines on patient outcomes, as in tonsillectomies, it can be included that the effectiveness of SIGN guidelines is mixed with some areas showing positive outcomes and some areas exposing potential problems to patients based on outdated and/or easy to misinterpret guidelines that need reviewing. However, it does not mean that the SIGN guidelines lacked potential negative impacts that are discussed.