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How to choose the most appropriate clinical practice guidelines(CPG)?

How to choose the most appropriate CPG?
All right. Where’s our destination? well we’re going to be looking at different disease state because there’s going to be guidelines for different disease states. So if you’re gonna have to look at something you want to treat a patient with urinary tract infections you’re gonna have to find that guideline. Smoking cessation so every disease state you can think of most of them have a guideline that you need to find and take into consideration when you’re treating your patients. So how do we search for them? Well I wish I could say it was easy. Different things you’re searching for I think it’s much easier to search for clinical trials in PubMed that it is to actually search for clinical practice guidelines.
So it’s often best if you know the national organization or you can figure out what the national organization is to try to look for it that way. You can also go there’s a couple of databases that you can use there’s one called DynaMed there’s pharmacist letter lexicon micromedex and 5-minute consult that all have sections on how to find or listed clinical practice guidelines Medline, CINAHL, Google Scholar a little bit more difficult and that’s why that’s listed next and then there’s some other databases trip database and guidelines gov. To me that’s one of the most difficult places to go. Because it started out as a good idea but now it just has too many guidelines .
And then we Google everything else so you might as well Google and see if you can find a guideline. Now what you’re gonna have to do with this? Especially until you become savvy at doing this. you’re going to have to it’s almost like your GPS. Now I know they don’t the GPS is don’t say this anymore because it would drive us crazy recalculating when you’d go the wrong way. Well that’s what you’re going to need to do. if you start it with the National organization and it doesn’t get you where you need to go.
You might need to go to Dynamed you might need to go to Medline until you actually get to the correct destination or the correct guideline that you’re looking for. So you just need to be patient. You just need to make sure you’re thorough and eventually you will find one if there is one. But you don’t want to waste your time looking at a guideline that isn’t the correct one. So a question I get all the time is how do I choose the most appropriate guide one.
Guideline well again there isn’t a guideline for proves choosing the appropriate guideline but there are some key things that you can use to make sure that you’re not wasting your time using one that’s not appropriate. Now I don’t know how many of you ever used highlights when you were a kid. But this is kind of what you’re gonna have to do In highlights what you did was you had two pictures it’s a little bit like finding Waldo if that would relate more to what you’re doing. You need to look and see very quickly what’s different about one picture versus and other. The key things that you’re looking for. That’s what you’re going to look at when you’re looking for guidelines.
You’re going to look for key things that are yes answers or no answers that will tell you whether it’s the right one or not. So the thing five are the important things that can really help you to find if it if it’s an appropriate guideline. Is an endorsed by a national U.S. organization? Now in the U.S., we use those if you’re in Europe you could punch lastly want to use those. In Taiwan I understand you use U.S. guidelines. So you’re going to want to make sure it’s endorsed by at least one if not multiple national organizations that are appropriate for that disease state. Does it contain both disease state and treatment recommendations?
And is it in the right population of patients that you’re looking for? Is it the full clinical practice guidelines ? That’s important. Again we don’t want summaries we don’t want updates we want to make sure it’s all there so we can find the key points that we want. Is it updated into the content current because if you just do a google search you may pull up an outdated guideline. You want to make sure you have the most recent one. The last one is it free to access. Most guidelines are free.
Now sometimes if you’re searching in a journal, there might be an embargo state a couple of months where you can’t get free access to it from but for the most part all clinical practice guidelines should be free for anyone to access to make sure that all clinicians are getting appropriate access to the most current guidelines to help with patient care. So let’s give an example of how you select the most appropriate clinical practice guideline and then this case let’s use the example of treatment of nausea and vomiting in pregnancy

Prof. Mary Ferrill shows the CPG search strategy in this video.

To begin with, there are many therapeutic disease states, such as UTIs (urinary tract infections). If we want to treat patients with UTIs, we need to know what kind of guideline we should follow.

Besides, we should pay attention to five matters when choosing appropriate guidelines.

Is it endorsed by a national US organization? Does it contain both disease state and treatment recommendations? Is it in the right population of patients that you are looking for? Is it a full clinical practice guideline? Is it updated into the content current? It is essential since we need to make sure we have the most recent one.

In the next video, we will be given an example of how to select the most appropriate clinical practice guideline.

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Evidence-Based Medicine in Clinical Pharmacy Practice

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