Working groups update
Guideline adaptation, a priority topic for G-I-N: results from a survey among G-I-N members
Guideline adaptation is a topic of high interest among G-I-N members. Soon after the annual conference in August 2010 in Chicago, the G-I-N Adaptation Working Group was established, co-chaired by Sue Phillips and Jako Burgers. To explore the views and preferences among G-I-N members around this topic, an electronic survey was conducted in autumn 2010. The survey was well-received and yielded interesting results from 112 respondents.
Definition and use of guideline adaptation
Guideline adaptation is the systematic approach to the endorsement and/or modification of a guideline(s) produced in one cultural and organisational setting for application in a different context. A large majority (88%) was familiar with this definition. Most respondents used one or several guidelines for adaptation in their country (45% and 58% respectively). Local adaptation was less common. (Figure 1)
Firgure 1 - Which approach to guideline adaptation in practice is applicable to your context?
Use of ADAPTE Manual and Toolkit
The ADAPTE Collaboration developed a Manual and Resource Toolkit for guideline adaptation (March 2010). Seventy-four percent of the respondents were familiar with this product and 45% of these resources in practice. Some respondents used other guideline adaptation methods such as CAN-IMPLEMENT, which is based on ADAPTE but has a stronger implementation component.
Most commonly perceived benefits of using the ADAPTE approach were:
- decreased time taken to develop guideline (39%);
- increase in transparency in the development process (36%);
- high quality of adapted guidelines achieved (35%);
- support in developing a guideline program (29%);
- decreased cost of development (28%).
Most commonly perceived barriers were:
- the complexity of the ADAPTE process (33%);
- timeframe to develop guideline only marginally decreased (31%)
- low quality of available guidelines (31%);
- resource use to develop/adapt guidelines only marginally decreased (28%);
- the need for training (28%).
Most respondents were satisfied with the ADAPTE approach with 72% rating it 4 or above using a 6-point Likert scale with 1 = unsatisfied and 6 = very satisfied (Figure 2). Nevertheless 61% of respondents thought that ADAPTE needs revision.
Figure 2 - Overall satisfaction with the ADAPTE approach
What should the G-I-N Adaptation working group do?
The G-I-N Adaptation working group aims to continue working on guideline adaptation. The respondents gave the following activities a high priority in the coming two years:
- Support methods for efficient guideline development through the use of existing guidelines and other sources of evidence syntheses (24%)
- Provide tutorials/training to groups undertaking or planning to undertake guideline adaptation (24%)
- Provide support to groups undertaking or planning to undertake guideline adaptation (22%)
- Refine the ADAPTE Manual and Resource Toolkit and develop additional tools (13%)
Other suggestions included developing a register of high quality guidelines, developing a framework for supporting de novo guideline development by international guidelines, and creating a forum for discussion.
Interest in joining the G-I-N Adaptation working group
The G-I-N Adaptation working group will have at least two teleconferences each year and one face-to-face meeting at the annual conference. Twenty seven respondents showed interest in participating in the working group and 29 respondents wished to be informed on its activities without active participation.
The survey showed that many G-I-N members are interested in guideline adaptation. The ADAPTE manual and toolkit can be considered as a good start but needs further elaboration. The G-I-N Adaptation Working Group should focus on the efficient sharing of existing guidelines and other evidence-based resources and on training and support for G-I-N members interested in guideline adaptation.
If you are interested in participating in the activities of the G-I-N adaptation working group please contact the G-I-N Office: firstname.lastname@example.org.
G-I-N Allied Health Community one year after its launch
About one year ago we announced the launch of the G-I-N Allied Health Community and we think it is about time to further introduce ourselves and provide you with an update of what we have done and what we are aiming for in the coming year.
Our objective is to promote and stimulate multidisciplinary collaboration in clinical guidelines, and to further facilitate and increase interactions between medical and allied health professionals. We therefore invite all types of health care professionals to join our activities.
After our launch a steering group was established to lead the activities of the community and a section on the G-I-N website was opened. We started our activities in two projects: (1) development of a toolkit to support nurses and allied health professionals in guideline development, and (2) the development of a position paper to promote patient functioning and quality of life in guidelines.
Development of a toolkit
By developing modules for (online) courses we aim to support nurses and allied health professionals in guideline development. The modules are being developed under auspices of the Royal College of Nursing (RCN). The project will result in five different modules which can be used in different ways, i.e. a full postgraduate program and brief (online) courses for separate modules. The next step is then to adapt these modules for wider use by allied health professionals in collaboration with the Chartered Society of Physiotherapy (CSP) and the Allied Health Professions Forum in the UK. Finally we want to develop a strategy for the international use of (online) courses within G-I-N.
Position paper to promote patient functioning and quality of life
The objective of this project is to develop a position paper to promote patient functioning and health related quality of life as objectives for prevention, assessment, treatment, and evaluation in clinical guidelines. The shift in health care from (only) medical diagnosis and treatment towards an integrative multidisciplinary approach should be reflected in guideline recommendations.
We received a grant of €10,000 from two G-I-N members (Regieraad and KNGF) to develop the paper and Simone van Dulmen recently started as junior researcher to develop the paper under auspices of the steering group. We expect to present a draft of the paper during the G-I-N conference in Seoul. To develop the position paper we have set up a wiki and we would like to invite you to contribute to the position paper. Details for accessing the wiki will be provided on the G-I-N website or you can contact Simone van Dulmen (email@example.com).
Our next steps are to expand the Allied Health community with a focus on the further stimulation of multidisciplinary collaboration in clinical guidelines. Our main message is that guidelines should emphasize the importance of a holistic approach and health related quality of life in guidelines, based on a patient centered approach.
Members of the G-I-N Allied Health Steering Group
Sarah Bazin, ER-WCPT (UK) Sue Lukersmith, Occupational Therapist (AU)
Dorien van Benthem, ACCC (NL) Josephine Muxlow, Nurse (CA)
Dunja Dreesens, Regieraad (NL) Else Poot, LEVV (NL)
Gerdien Franx, Trimbos (NL) Elaine Santa Mina, Nurse (CA)
Jenny Gordon, RCN (UK) Philip van der Wees, KNGF (NL), Chair