Article type
Abstract
Background: Patient-relevant context factors are of crucial importance in the care of 'real' patients. Guideline groups thus face the challenge of developing patient-centred, not disease-centred, guidelines. In this context, the consideration of patient-relevant context factors is crucial to increase the acceptance of guidelines in clinical practice and may improve the care of 'real' patients.
Objectives: To identify patient-relevant context factors that are crucial for the development of guidelines and to evaluate their consideration in the recommendations of selected guidelines.
Methods: The following patient-relevant context factors were operationalised and further examined on the basis of the classification by Wyatt et al. (3): co- and multi-morbidity, the social and personal context of patients as well as their personal values and preferences. The evaluation was performed on the basis of all guidelines published in 2016 by the German Association of the Scientific Medical Professional Societies (AWMF) as well as guidelines newly published in 2016 by the Scottish Intercollegiate Guidelines Network (SIGN) and the English National Institute for Health and Care Excellence (NICE).
Results: A total of 23 German, 4 Scottish (SIGN) and 28 English (NICE) guidelines were included. Of the context factors investigated, the recommendations in the German guidelines primarily contained statements on co- and multi-morbidity, in which it often remained unclear how the comorbidities mentioned had been selected. The social and personal context of patients, as well as their personal values and preferences, were hardly addressed explicitly in the recommendations, or not addressed at all. The analysis of the SIGN and NICE guidelines is ongoing and these results will also be presented at the Summit.
Conclusions: The first results of our analysis show that those patient-relevant context factors that are highly relevant to patients have so far hardly been evident in the reality of guidelines. It would thus be important to further develop the operationalisation of context factors and increase awareness in guideline groups.
Objectives: To identify patient-relevant context factors that are crucial for the development of guidelines and to evaluate their consideration in the recommendations of selected guidelines.
Methods: The following patient-relevant context factors were operationalised and further examined on the basis of the classification by Wyatt et al. (3): co- and multi-morbidity, the social and personal context of patients as well as their personal values and preferences. The evaluation was performed on the basis of all guidelines published in 2016 by the German Association of the Scientific Medical Professional Societies (AWMF) as well as guidelines newly published in 2016 by the Scottish Intercollegiate Guidelines Network (SIGN) and the English National Institute for Health and Care Excellence (NICE).
Results: A total of 23 German, 4 Scottish (SIGN) and 28 English (NICE) guidelines were included. Of the context factors investigated, the recommendations in the German guidelines primarily contained statements on co- and multi-morbidity, in which it often remained unclear how the comorbidities mentioned had been selected. The social and personal context of patients, as well as their personal values and preferences, were hardly addressed explicitly in the recommendations, or not addressed at all. The analysis of the SIGN and NICE guidelines is ongoing and these results will also be presented at the Summit.
Conclusions: The first results of our analysis show that those patient-relevant context factors that are highly relevant to patients have so far hardly been evident in the reality of guidelines. It would thus be important to further develop the operationalisation of context factors and increase awareness in guideline groups.