Evaluation of the asthma guideline implementation project in the Western Cape, South Africa
Introduction: Asthma is the eighth leading contributor to the burden of disease in South Africa. Previous guidelines have been published in scientific journals with no explicit approach to their dissemination and implementation. The Asthma Guideline Implementation Project (AGIP) attempted to design, monitor and evaluate a model for guideline dissemination and implementation in the Western Cape. The project focused on the new guideline for the management of chronic asthma in adults and adolescents. Methods: Outcome Mapping was used to design, monitor and evaluate the project. Seven boundary partners were targeted by the project - patients, primary care providers, medical schemes, Department of Health, universities and training bodies, pharmaceutical industry and hospital-based physicians. Thirteen strategies were planned to engage with and influence these boundary partners. Results: More than 50% of the planned changes were achieved among all the boundary partners, except for the medical schemes. Greatest success was seen with patients, primary care providers and the Department of Health. The AGIP developed self-management/education leaflets, group education tools and DVD materials for patients; desktop manuals, wall-charts, audit tools, and interactive workshops for primary care providers. Conclusion: AGIP have shown how new guidelines can be disseminated and implemented in a multi-faceted and more effective way than simply publishing in a scientific journal. The resource materials and strategies developed by AGIP have been offered to other provinces via the National Asthma Education Programme and National Department of Health.