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Related Experiment Videos

Adding "value" to clinical practice guidelines.

James P McCormack1, Peter Loewen

  • 1Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver. jmccorma@interchange.ubc.ca

Canadian Family Physician Medecin De Famille Canadien
|September 18, 2007
PubMed
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Canadian clinical practice guidelines for chronic conditions offer limited guidance on incorporating patient values and preferences into decision-making. These guidelines also provide insufficient quantitative data on treatment benefits and harms for shared decision-making.

Area of Science:

  • Health Services Research
  • Clinical Practice Guidelines
  • Shared Decision-Making

Background:

  • Shared decision-making is a cornerstone of evidence-based practice, emphasizing patient involvement.
  • Clinical practice guidelines (CPGs) are crucial for informing therapeutic decisions in chronic disease management.
  • The integration of patient values and preferences is essential for effective shared decision-making.

Purpose of the Study:

  • To assess the extent to which Canadian CPGs for diabetes, dyslipidemias, hypertension, and osteoporosis address patient values and preferences.
  • To evaluate the availability of quantitative information within these CPGs to support informed patient decision-making.

Main Methods:

  • A retrospective, observational review of five prominent Canadian CPGs.

Related Experiment Videos

  • Analysis focused on mentions of patient values/preferences, quantitative benefit/harm data, and cost information.
  • Evaluated the applicability of quantitative data for individual patient decision-making.

    • Main Results:

    • Only three of five CPGs mentioned the importance of patient values in treatment decisions.
    • None recommended discussing therapy benefits and harms with patients.
    • Most quantitative data on therapeutic effects were relative (81%), with limited applicability for individual decisions; harm and cost information was sparse.

    Conclusions:

    • Canadian CPGs for common chronic conditions inadequately incorporate patient values and preferences.
    • The limited quantitative information provided hinders clinicians' ability to facilitate comprehensive shared informed decision-making.
    • There is a significant gap in guideline development regarding patient-centered care and evidence-based decision-making.