Stakeholder perceptions of 'guidance and standards' for developing clinical practice guidance in Ireland

Clinical practice guidance (CPG) needs to be developed following robust standards that are acceptable to end users.

This descriptive qualitative study aimed to explore stakeholder experiences and perceptions of standards for CPG development in Ireland.

Twenty stakeholders (senior decision-makers, evidence synthesis specialists, healthcare providers and guideline developers) participated in semi-structured interviews, conducted remotely via Microsoft Teams between November 2023 to January 2024 by one interviewer. The topic guide was informed by a previous scoping review and an existing 2015 standards document. All interviews were audio-recorded and transcribed verbatim. Data analysis followed a framework approach.

Many participants recognised the value of having standards for CPG development but expressed limited familiarity with specific documents. They described a complex landscape of CPG development and use in Ireland, causing confusion due to ambiguous terminology and uncertainty regarding which guidance is required/takes precedence in various healthcare scenarios. Participants spoke to the importance of governance, particularly planning robust audit processes when developing CPGs. They also highlighted variation in CPG implementation and felt that those developing CPGs often failed to adequately consider implementation and communication planning. The need for more resources, particularly personnel like methodologists, to support developing evidence-based CPG was a recurring theme.

This qualitative study underscores stakeholders' appreciation of manuals and documents on developing CPG, yet it also highlights gaps in awareness and practical application. There is a pressing need for better promotion and dissemination of resources for development and implementation within the guidance development ecosystem.