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How can clinical practice guidelines be adapted to facilitate shared decision making? A qualitative key-informant
Trudy van der Weijden1, Arwen H Pieterse, Marije S Koelewijn-van Loon
1Department of General Practice, CAPHRI School of Public Health and Primary Care, Maastricht University, , Maastricht, The Netherlands.
BMJ Quality & Safety
|June 11, 2013
Summary
Clinical practice guidelines can be adapted to better support shared decision-making. Strategies include patient-friendly language, patient versions of guidelines, and embedded decision support tools for improved patient involvement.
Area of Science:
- Health Services Research
- Clinical Practice Guidelines
- Shared Decision Making
Background:
- Clinical practice guidelines (CPGs) are crucial for evidence-based care.
- Facilitating shared decision-making (SDM) is essential for patient-centered care.
- Adapting CPGs to support SDM requires specific strategies.
Purpose of the Study:
- To explore methods for adapting clinical practice guidelines.
- To enhance the integration of shared decision-making into guideline development and use.
- To identify strategies for improving patient involvement in treatment decisions.
Main Methods:
- Qualitative key-informant study involving group discussions and semi-structured interviews.
- Engaged 75 experts in guideline development and SDM in group discussions.
- Conducted interviews with 20 health professionals and patient representatives using illustrative treatment decisions.
Main Results:
- Generic strategies include dedicated SDM chapters, patient-engaging language, and patient versions of guidelines.
- Recommendation-specific strategies involve structuring healthcare options, facilitating deliberation, and embedding patient support tools.
- Identified approaches to increase professional awareness of options and support patient-provider discussions.
Conclusions:
- An overview of strategies for adapting CPGs to facilitate SDM was developed.
- Some proposed strategies may be more controversial than others.
- Further research is needed to assess the feasibility and impact of these adaptation strategies.
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