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Canadian guidelines for clinical practice : an analysis of their quality and relevance to the care of adults with comorbidity

Fortin Martin, Contant Eric, Savard Catherine, Hudon Catherine, Poitras Marie-Ève et Almirall José. (2011). Canadian guidelines for clinical practice : an analysis of their quality and relevance to the care of adults with comorbidity. BMC Family Practice, 12, p. 74.

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URL officielle: https://doi.org/10.1186/1471-2296-12-74

Résumé

Background: Clinical guidelines have been the subject of much criticism in primary care literature partly due to potential conflicts in their implementation among patients with multiple chronic conditions. We assessed the relevance of selected Canadian clinical guidelines on chronic diseases for patients with comorbidity and examined their quality.

Methods: We selected 16 chronic medical conditions according to their frequency of occurrence, complexity of treatment, and pertinence to primary care. Recent Canadian clinical guidelines (2004 - 2009) on these conditions, published in English or French, were retrieved. We assessed guideline relevance to the care of patients with comorbidity with a tool developed by Boyd and colleagues. Quality was assessed using the Appraisal of Guidelines Research and Evaluation (AGREE) instrument.

Results: Regarding relevance, 56.2% of guidelines addressed treatment for patients with multiple chronic conditions and 18.8% addressed the issue for older patients. Fifteen guidelines (93.8%) included specific recommendations for patients with one concurrent condition; only three guidelines (18.8%) addressed specific recommendations for patients with two comorbid conditions and one for more than two concurrent comorbid conditions. Quality of the evaluated guidelines was good to very good in four out of the six domains measured using the AGREE instrument. The domains with lower mean scores were Stakeholder Involvement and Applicability.

Conclusions: The quality of the Canadian guidelines examined is generally good, yet their relevance for patients with two or more chronic conditions is very limited and there is room for improvement in this respect.

Type de document:Article publié dans une revue avec comité d'évaluation
Volume:12
Pages:p. 74
Version évaluée par les pairs:Oui
Date:Juillet 2011
Sujets:Sciences de la santé
Sciences de la santé > Sciences infirmières
Sciences de la santé > Sciences médicales
Département, module, service et unité de recherche:Départements et modules > Département des sciences de la santé > Module des sciences infirmières
Mots-clés:Chronic obstructive pulmonary disease, comorbid condition, chronic medical condition, stakeholder involvement, multiple chronic condition, chronic disease, practice guidelines, maladie pulmonaire obstructive chronique, comorbidité, maladie chronique, état chronique multiple, guide de pratique
Déposé le:11 déc. 2018 02:08
Dernière modification:11 déc. 2018 02:08
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