Background: NCDs, including heart disease, stroke, cancer, type 2 diabetes mellitus (T2DM) and chronic lung disease, are responsible for almost 70% of deaths worldwide. In Colombia, more than 110 thousand die due to NCDs each year. Adequate self-management presents a potentially scalable way of mitigating the growing burden of NCDs. As part of a NCDs clinical practice guidelines (CPG) implementation project in Colombia, we seek to identify strategies that allow the patient to be empowered by current recommendations about their disease. This abstract presents the experience we have had with patient/caregiver/physician involvement in CPG implementation.
Objectives: To assess the patient/caregiver/physician involvement strategy as part of the NCDs guideline implementation process.
Methods: Before starting the CPG implementation process, we decided to prioritize those recommendations that required special efforts to be implemented. Criteria for priority were: recommendations based on high quality evidence, potential feasibility, and low frequency of implementation. The study team selected the recommendations based on the first criteria. To apply all other criteria, we involved expert physicians, patients and caregivers. We invited patients/caregivers using local media campaigns and presentations in patient groups. Physicians were invited by personal communication considering their background in internal medicine and ambulatory practice. Criteria for participants were: being a patient or caregiver for one of the NCDs of interest (high blood pressure [HBP] or T2DM), having the time for completing the project activities, and giving informed consent. Participants attended a four-session training workshop in fundamentals of evidence-based practice; different sessions were planned for patients/caregivers and for physicians. Participants completing the workshop successfully took part of any of the two selection panels (one panel for each condition). Panels met three times with specific objectives: (1)To evaluate the understanding of the recommendation; (2)To introduce modifications in the presentation and wording of the recommendation according to public perceptions and suggestions; (3)To approve the final version of modified recommendations. The experience was assessed using questionnaires completed by all type of participants at the end of the process.
Results: HBP and T2DM national guidelines present a total of 68 recommendations, 40 based on high quality evidence. A total of 12 patients, 8 caregivers and 15 physicians were involved. 21 completed the training workshops and took part of the selection panels. The study results include: demographic characteristics of participants, type of contributions made by patients/caregivers/physicians, perceptions of feasibility, suggestions for making recommendations clearer and more understandable from patients/caregiver/physician perspective.
Patient or healthcare consumer involvement: Early public involvement seems to be a strategy to achieve better results in the local implementation process of CPGs.