Implementation of the transparent and rigour evidence-based methodology of clinical practice guideline development in the Czech Republic

Article type
Authors
Klugarova J1, Vrbova T2, Pokorna A1, Licenik R3, Dusek L4, Klugar M5
1Masaryk University, Faculty of Medicine, ​Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Rep./Czech JBI Centre of Excelence/MUNI GRADE Centre); Institute of Health Information and Statistics of the Czech Rep.
2Czech Health Research Council
3Masaryk University, Faculty of Medicine, ​Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Rep./Czech JBI Centre of Excellence/MUNI GRADE Centre); Czech Health Research Council
4Institute of Health Information and Statistics of the Czech Republic
5Masaryk University, Faculty of Medicine, ​Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Rep/Czech JBI Centre of Excellence/MUNI GRADE Centre); Institute of Health Information and Statistics of the Czech Rep.
Abstract
Background:
Currently, in the Czech Republic, there does not exist such an institution as “National Centre for Clinical Practice Guidelines”, which would systematically collaborate with all relevant stakeholders in the Czech Health System. There is high heterogeneity in level and also in a type of indicated care among healthcare facilities. In 2018, we established Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (CEBHC-KT) as the Czech methodological hub and umbrella for the Cochrane Czech Republic, Masaryk University Grade Centre and the Czech Republic Centre for Evidence-Based Healthcare: The Joanna Briggs Institute Centre of Excellence. Within the national guidelines project led by the Czech Health Research Council together with Ministry of Health of the Czech Republic and Institute of Health Information and Statistics of the Czech Republic, we developed the Czech National methodology of the Clinical Practice Guideline development based on GRADE approach.
Objectives:
The main aim of this project is to implement the transparent and rigour Evidence-based methodology of clinical practice guideline development into the Czech Health System.
Methods:
The Czech National methodology of the Clinical Practice Guideline (CPGs) development is being implemented in the Czech Republic using Joanna Briggs Institute model for implementation based on the clinical audit, GRiP strategy (Getting Research into Practice), follow-up audit and feedback. This implementation project is part of European ERASMUS+ project ”Strategic Partnership in Innovation and Development of Evidence-Based Healthcare”.
Results:
Baseline audit showed that in March 2017, there were 123 professional healthcare organizations which developed 1909 CPGs. However, the majority of these CPGs were “expert opinion” or “consensual” based guidelines lacking in vast majority Evidence-Based Medicine principles and methods. There was no CPG developed based on the GRADE approach. As main obstacles of implementation of the Czech national CPG methodology were identified: lack of knowledge of CPG development among all types of healthcare professionals including chairpeople of the professional medical and allied health care organizations who are responsible for CPG development, and also missing motivation for high-quality CPG development and use. That is why workshops focused on CPG development, including systematic review and GRADE methodology combined with individual cooperation with teams developing CPGs, were organised. Currently, we have developed 12 Evidence-based trustworthy CPGs, and we are working on another 28.
Conclusions:
Implementation is a crucial part of EBHC approach. However, essential is to choose the suitable implementation model and especially get on board key stakeholders regarding the topic of the change.
Patient or healthcare consumer involvement:
Chairman of the Patients board is a member of the Guarantee committee of the CPG Project, approving topics of new CPGs and also approving completed / final version of CPGs in the Czech Republic.