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Introduction: Clinical Practice Guidelines

Introduction: Clinical Practice Guidelines
So the last session I’ll present is on clinical practice guidelines and you might recall in each one of my sessions I’ve mentioned them how the importance of including them in our analysis of articles. So I think it’s very important as the reader to be able to understand what clinical practice guidelines tell us what they don’t tell us and how to interpret them in the total picture of our literature evaluation. So you can see that they go in order to get a practice guideline you have the literature review, consensus process, evidence evaluation and then they create it. It’s reviewed. It’s published. it’s disseminated and then it goes into use.
So for the learning objectives for this section we’re going to look at the terminology associated with evidence-based medicine which I’ll also refer to as EBM and then clinical practice guidelines which I’ll often refer to CPGs and differentiate them from consensus statements consensus panels, conference proceedings, executive summaries physicians or summary statements. We’re going to compare and compress some benefits and barriers to the use of CPGs. We’re going to identify resources that provide access to you as the reader to them. Also help you to develop a search strategy to locate them when you need to look up certain disease states.
And then also how to select the most appropriate CPG It’ ‘ll be nice if there was only one clear winner for each disease state but it just depends on what you’re looking for. And then we’re gonna look at five key things It’ll be listed as “think five” that we should look at to help either confirm or question the clinical practice guideline that we found.
We’re also gonna interpret the level of evidence which is going to be key for us to be able to extrapolate that information to patient care and the level of it evidence is listed by grade or level and we’ll look at these in the context of CPG and then describe the ultimate purpose of a CPG with regards to how it should be used in clinical practice. So hopefully you consider yourself a medication experts other people in other fields do. So we need to make sure that we’re looking at the most appropriate treatment and management to be able to truly use evany evidence-based medicine for our patients. So what exactly is a CPG?
Well I would think of it kind of as a road map. And they’re developed by expert panels and national organizations and using a thorough analysis of the literature and also peer assessment to come up with recommendations and algorithms that can help guide a clinician, guide, not dictate, guide, to be able to provide specific information to help clinicians make good treatment options for specific disease states. CPGs are designed to apply to most patients in most situations, but they are not meant to be a lockstep approach to treatment that must be strictly followed. If this is the only thing that you remember from this section of the presentation, this is what’s important.
we’ll go over unfortunately the guidelines have become a too commonplace and too lockstep and we need to make sure that we’re taking individual patients needs and issues into consideration when we’re making treatment plans. So I mentioned we’re going to go over some terminology to make sure I talked to you about what CPGs are the rest of these are not Consensus statements are reports and they often are used to supplement their by consensus panels but they’re not the full report it’s often easy to tell a difference because they’re shorter in pages than those but a consensus statement is not considered a full clinical practice guideline.
Executive summary are often used to give you a quick look at what the guidelines are which may be alright if you’re looking for a specific piece of information but you really need to make sure you understand what’s in the complete guide line before you provide any recommendation. Now updates to CPGs are not full reports they’re often published some of them are published on a yearly basis supplement what was there so you need to make sure you review those including the full last updated guideline.
Position or summary statements are official points of view often happened with specific organizations but again are not full reports and should not be used as such Alright so I talked about that there were four benefits and four barriers to using CPGs. Now benefits, it does facilitate in helping make decisions and it makes for more quality decisions and consistent decisions but the barriers are a lack of awareness. Not everybody looks at guidelines and a raise aware of which ones are there and also not always knowing which ones are the most common.
It also improves quality of healthcare because again you have some more standard potential treatments but a lack of agreement not everyone agrees with what the guidelines say and I’m going to show you example of that. Minimizes professional liability but then the flip side is also it could be viewed as cookie cutter medicine and would lead to a decrease in the professionalism potentially the people using them because they aren’t able to provide specific recommendations. They’re just using the algorithms as such and not deviating from them.
Again talked about provides some consistency among treatment but as we’ll see there’s just too many credit clinical practice guidelines from different organizations that often conflict with each other and so I would imagine some health care providers just throw up our hands and say I’ll just do what I need to do because this is too much to look at.

Prof. Mary Ferrill gives a brief introduction to clinical practice guidelines (CPG) and the learning objectives for this lesson.

To begin with, it is very important for us to be able to understand what clinical practice guidelines tell us, what they don’t tell us, and how to interpret them in our literature evaluation.

According to the flow diagram, we can know the steps forming CPGs, including literature review, CPG creation, CPG Dissemination, and CPG in use in a healthcare organization.

What are CPGs? They contain recommendations, algorithms, and help clinicians determine optimal treatment approaches for specific disease states. They are designed to apply to MOST patients in MOST situations, but they are NOT MEANT to be a lock-step approach to treatment.

Besides, we need to know 4 terminologies, including Consensus Statements, Executive Summary, Updates to CPGs, and Position or Summary Statements.

Finally, there some benefits and barriers of CPGs. Have you faced any problem with CPGs in your work? Please share it below.

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Evidence-Based Medicine in Clinical Pharmacy Practice

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