This CSO funded cluster randomised trial evaluated the effectiveness and efficiency of a tailored multifaceted strategy, delivered by a national clinical effectiveness programme, to implement a guideline on induced abortion. 26 hospital gynaecology units in Scotland received either standard care or a package comprising audit and feedback, unit educational meetings, dissemination of structured case records. The results showed no differences for any key recommendation: appointment with a gynaecologist within five days of referral; ascertainment of cervical cytology history; antibiotic prophylaxis or screening for lower genital tract infection; use of misoprostol as an alternative to gemeprost; and offer of contraceptive supplies at discharge.
The study concluded that the tailored multifaceted strategy was ineffective. This was possibly attributable to high preintervention compliance and the limited impact of the strategy on factors outside the perceived control of clinical staff.
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