Implementation science promotes clinical practice of guidelines: a scoping review

Abstract

BACKGROUND: The standardized professional conduct of medical staff and the consistent delivery of healthcare services depend on the continuous dissemination and implementation of clinical practice guidelines. However, a notable gap exists between guidelines publication and their real-world application, highlighting the need for robust methodologies to support evidence translation. Implementation science (IS) facilitates the adoption and integration of evidence-based practices, interventions, and policies within real-world healthcare and public health contexts. This scoping review aims to clarify how IS is applied in guidelines implementation, identify study characteristics, and guide medical staff in translating guidelines recommendations into actionable clinical practices. METHODS: Six electronic databases, including PubMed, Embase, Cochrane Library, Web of Science, CINAHL, and Scopus, were searched from their inception to July 17, 2025. Studies were selected based on predefined eligibility criteria, and relevant data were extracted by two reviewers using a standardized form. Quantitative and qualitative analyses were performed to assess research scope, trends, and characteristics. The results are presented in tables, accompanied by relevant visualizations where appropriate. RESULTS: A total of 8, 929 studies were identified, of which 99 met the inclusion criteria and underwent data extraction and synthesis. A bar chart illustrates the temporal distribution of included studies by publication year. The most common study designs were qualitative (n = 32) and observational (n = 13). A word cloud highlights primary healthcare topics addressed, including chronic diseases healthcare, maternal and infant healthcare, nervous system disease healthcare, symptom management. Among the included studies, 66 were multi-center. Hospitals were the predominant practice setting (n = 27), followed by primary care (n = 19). Studies primarily focused on patients with specialized diseases (n = 56). The most frequent study objectives were understanding current status and investigating barriers and facilitators. Provider teams constituted the most commonly involved stakeholder group, followed by patients and families. Reporting of constituting organizations occurred in 56.6% of studies, while 78.8% reported guidelines references. Regarding implementation frameworks, 63 studies applied a single framework, 21 utilized multiple frameworks, and determinant frameworks—particularly the Consolidated Framework for Implementation Research (CFIR) and the Theoretical Domains Framework (TDF)—were the most widely applied. CONCLUSION: Generally, using IS in guidelines has received considerable attention but remains unsatisfactory. There is a critical need for methodological standardization, high-quality guidelines selection and their detail disclosure, stronger collaboration among all relevant stakeholders in the application of IS in guidelines. Sustained and coordinated support can foster large-scale, high-quality, and scientifically rigorous guidelines implementation studies, thereby yielding superior implementation outcomes. TRIAL REGISTRATION: Open Science Frame (OSF: https://doi.org/10.17605/OSF.IO/Q9RWE ).

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