Article type
Abstract
Background
Minor ailments can be defined as non-complicated medical conditions that can be self-diagnosed and managed with or without support of a healthcare professional. Examples are nose bleeding, stubbed toe, clogged ear and insect bite. The Dutch College of General Practitioners runs a large evidence-based guideline program but minor ailments are not covered due to limited evidence. However, evidence-based recommendations on managing minor ailments in daily life can still be helpful, both for patients (supporting self-management) and for general practitioners (reducing workload).
Objectives
To develop and evaluate a method for development of recommendations on managing minor ailments by patients.
Methods
We drafted a guide for developing recommendations and good practice statements based on an existing guide using the GRADE method. Compared to standard guideline development, the number of questions and available evidence is limited. If no evidence is available, guiding principles in formulating recommendations are ‘in dubio abstine’ and watchful waiting. Next, we composed a panel of seven practicing general practitioners with research expertise, two practice assistants, one patient representative, and one guideline methodologist. Nose bleeding was selected as topic to test the acceptance and feasibility of the process.
Results
The panel selected 7 questions on management and prevention of nose bleeding. The literature review yielded 2 guidelines, 2 systematic reviews, 1 RCT and 1 observational study of very low quality. None of these could answer our questions, such as how long the nose should be closed by compression, in which position, and whether blowing the nose is useful before compression. Based on expert opinion and consensus within the panel we could formulate good practice statements that largely follow existing education and advice to patients in general practice.
Conclusions
Dealing with the absence of evidence in developing guidelines is challenging but feasible following a structured process with a panel of experts with experience in general practice. Recommendations and good practice statements on minor ailments for general practitioners as well as patients are helpful to support self-management and could reduce burden for general practitioners. Further research is needed for evaluating the acceptance and use in practice.
Minor ailments can be defined as non-complicated medical conditions that can be self-diagnosed and managed with or without support of a healthcare professional. Examples are nose bleeding, stubbed toe, clogged ear and insect bite. The Dutch College of General Practitioners runs a large evidence-based guideline program but minor ailments are not covered due to limited evidence. However, evidence-based recommendations on managing minor ailments in daily life can still be helpful, both for patients (supporting self-management) and for general practitioners (reducing workload).
Objectives
To develop and evaluate a method for development of recommendations on managing minor ailments by patients.
Methods
We drafted a guide for developing recommendations and good practice statements based on an existing guide using the GRADE method. Compared to standard guideline development, the number of questions and available evidence is limited. If no evidence is available, guiding principles in formulating recommendations are ‘in dubio abstine’ and watchful waiting. Next, we composed a panel of seven practicing general practitioners with research expertise, two practice assistants, one patient representative, and one guideline methodologist. Nose bleeding was selected as topic to test the acceptance and feasibility of the process.
Results
The panel selected 7 questions on management and prevention of nose bleeding. The literature review yielded 2 guidelines, 2 systematic reviews, 1 RCT and 1 observational study of very low quality. None of these could answer our questions, such as how long the nose should be closed by compression, in which position, and whether blowing the nose is useful before compression. Based on expert opinion and consensus within the panel we could formulate good practice statements that largely follow existing education and advice to patients in general practice.
Conclusions
Dealing with the absence of evidence in developing guidelines is challenging but feasible following a structured process with a panel of experts with experience in general practice. Recommendations and good practice statements on minor ailments for general practitioners as well as patients are helpful to support self-management and could reduce burden for general practitioners. Further research is needed for evaluating the acceptance and use in practice.