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A Protocol to Develop Practice Guidelines for Primary Care Medical Service Trips.

Christopher Dainton1, Charlene H Chu2, Henry Lin3

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Summary

A new 5-step methodology helps medical service trip (MST) clinicians develop evidence-based, locally adapted treatment protocols. This process enhances patient care in Latin America and the Caribbean by integrating local knowledge and equitable considerations.

Keywords:
Latin Americaglobal healthhumanitarian healthinternational healthmedical missionsmedical service trips

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Area of Science:

  • Global Health
  • Medical Education
  • Health Policy

Background:

  • North American clinicians increasingly participate in medical service trips (MSTs) in Latin America and the Caribbean.
  • Limited use of evidence-based guidelines by MSTs poses potential risks to patient care.
  • There is a need for standardized, adaptable protocols for primary healthcare delivery during MSTs.

Purpose of the Study:

  • To propose a 5-step methodology for developing diagnostic and treatment protocols for conditions encountered by MST clinicians.
  • To adapt existing guideline development frameworks for the unique context of MSTs.
  • To create a process that ensures protocols are evidence-based, equitable, and locally relevant.

Main Methods:

  • Adapted the American College of Physicians guidance statement on guideline development.
  • Incorporated a 5-step process including environmental scans, guideline reviews, literature assessments, eDelphi consensus, and peer review.
  • Focused on evidence, equity, and local adaptation considerations throughout the methodology development.

Main Results:

  • Developed a 5-step methodology for creating locally optimized protocols for common conditions seen in MSTs.
  • The process involves environmental scans of existing protocols, review of guidelines and literature, expert consensus (eDelphi), and external peer review.
  • This systematic approach ensures protocols address epidemiology, diagnosis, and treatment effectively.

Conclusions:

  • The proposed protocol facilitates the creation of practice guidelines grounded in best evidence, local knowledge, and equity.
  • Implementing this process can optimize MST operations and improve healthcare delivery.
  • Prioritizing input from local community partners is crucial for successful guideline development and implementation.