Unit v - Contemporary Healthcare Information

8/10/2019 Unit v - Contemporary Healthcare Information

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Contemporary

Healthcare Information

Charliemaign Stanley S. Cruz, MSc.,

R.Ph.Faculty of Pharmacy



Contents

• Clinical Practice Guidline

• Principles for Practice Guideline development

•

Evaluating Practice Guidelines• Limitations of Implementing Practice

Guidelines

•Role of Pharmacist



Clinical Practice Guideline

• Is a set of protocols in managing specific

healthcare conditions

• Includes management flow charts and clinical

decision diagrams



Clinical Practice Guideline

• Use in Clinical Decision Making:

– Improve quality of healthcare

– Reduce the use of the following:

• Unnecessary meds• Ineffective meds

• Harmful meds

– Facilitate treatment of patients

• Maximum benefit

• Minimum risk of harm

• Acceptable cost



PRACTICE GUIDELINEDEVELOPMENT



9 Key Principles

1. Processes for developing and evaluating

clinical practice guideline should focus on

outcome

• Outcomes

– Ranges from survival rates to quality-of-life

attributes



9 Key Principles

2. Clinical practice guidelines should be based on

best available evidence

• Evidence can be graded according to “level,

quality, relevance and strength”

– Level : study design used to minimize bias

– Quality : methods used to minimize bias in the design

– Relevance : extent to which findings can be applied – Strength : relates to the magnitude and reliability of

treatment effect in clinical studies



9 Key Principles

3. The methods used to synthesize the best

evidence should be the strongest applicable

“The fact of having evidence from a high-level

study does not automatically result in a good

clinical recommendation, it has to be

APPLICABLE.”



9 Key Principles

4. The process of guideline development

should be multidisciplinary and should

include consumers.

“If guidelines are to be relevant, those who are

expected to use them or benefit from them

should take part in their conception”



9 Key Principles

5. Guidelines should be flexible and adaptable

to varying factors

• Factors:

– Different target populations

– Geographic settings

– Clinical settings

– Cost and constraints

– Patient preference and values



9 Key Principles

6. Guidelines should be developed with

resource constraints in mind incorporating

economic appraisal

• Economic appraisal of guidelines is helpful

during choosing between treatment options



9 Key Principles

7. Guidelines are developed to be disseminated

and implemented taking into account their

target audiences

• Audience includes patients and practitioners

• Dissemination can be made:

– Different media

– Different technology

“Dissemination will not change practitioner’s

behavior, they have to be involved in the change

process”



9 Key Principles

8. The implementation and impact of

guidelines should be evaluated.

9. Guidelines should be revised regularly

– Regular revision ensures that guidelines are

updated based on best evidence available



CLINICAL PRACTICE GUIDELINEEVALUATION



Consider the following;

1. How well were they disseminated?

2. Is the general trend in clinical practice moving

towards the guideline recommendations?

3. Have the guidelines contributed to any

specific changes in clinical practice?

4. How have the guidelines affected consumers’

knowledge and understanding?

5. Have health outcomes changed?



LIMITATION OF CLINICAL PRACTICEGUIDELINE



Limitations

• The most important limitation is that therecommendation is WRONG.

• The promotion of flawed guidelines canencourage, if not institutionalize, the delivery

of ineffective, harmful, or wasteful

interventions.

• The same parties that stand to benefit fromguidelines— patients, healthcare

professionals, the healthcare system—may all



Limitation

1. Scientific evidence about what to recommend is

often lacking misleading, or misinterpreted.

– Misleading findings

–Poor generalization

– Lack of time and skill for detailed scrutiny of evidences



Limitation

2. Recommendations are influenced by the opinions

and clinical experience and composition of the

guideline development group

–Test and treatments can be inferior contrary to commonbelief

– Beliefs of individual experts may result in misconception



Limitation

3. Patients’ needs may not be the only priority in

making recommendations

– Suboptimal procedures may be recommended

•

Control cost• Address social needs

• Protect special interest



Role of the Pharmacist

• Be involved Guideline development

• Share vital information about pharmacy-

related concepts

• Disseminate information about guideline

guidelines

• Personally assess the impact of using

guidelines to patient QOL



THANK YOU

Documents

Unit v - Contemporary Healthcare Information