Evidence‐based clinical guidelines ‐ implementation plans in Scotland

1997 ◽  
Vol 10 (6) ◽  
pp. 236-240 ◽  
Author(s):  
Andrew Millard
Keyword(s):  
Clinical Guidelines ◽  
Evidence Based ◽  
Guidelines Implementation ◽  
Implementation Plans

scholarly journals What is the content of virtually delivered pain management programmes for people with persistent musculoskeletal pain? A systematic review

2021 ◽  
pp. 204946372110230
Author(s):  
Gregory Booth ◽  
Deborah Williams ◽  
Hasina Patel ◽  
Anthony W Gilbert
Keyword(s):  
Systematic Review ◽  
Pain Management ◽  
Musculoskeletal Pain ◽  
Clinical Guidelines ◽  
Reporting Quality ◽  
Skills Training ◽  
Evidence Based ◽  
Core Element ◽  
Multidisciplinary Pain Management ◽  
Pain Services

Introduction: Virtual consultations (VC) have been embraced by healthcare organisations during the COVID-19 pandemic. VC allows continuation of patient care while adhering to government advised restrictions and social distancing measures. Multidisciplinary pain management programmes (PMPs) are a core element of many pain services and utilising virtual methods to deliver PMPs has allowed them to continue to provide care. This systematic review aimed to explore the content of existing virtually delivered PMPs and discuss if and how these findings can be used to guide clinical delivery. Methods: Eligible studies included adults (aged ⩾18 years) with persistent musculoskeletal pain and any virtually delivered intervention that was described as a PMP or that had components of PMPs. Databases were searched from inception until July 2020. We performed a content analysis comparing existing interventions with established evidence-based clinical guidelines published by the British Pain Society (BPS). Intervention reporting quality was assessed using the Template for Intervention Description and Replication (TIDieR) checklist: an established checklist developed to improve the completeness of the reporting of interventions. Results: Eight studies were included. One intervention included six of the seven components recommended by the BPS; none included all seven. ‘Skills training and activity management’ was present in all eight interventions; ‘education’ and ‘cognitive therapy methods’ were present in six interventions; ‘graded activation’ and ‘methods to enhance acceptance, mindfulness and psychological flexibility’ were present in four interventions; ‘physical exercise’ was present in two interventions and ‘graded exposure’ was present in one intervention. None of the studies described all 12 items of the TIDieR checklist adequately enough for replication. Conclusion: Published virtual PMPs partially meet established clinical guidelines. Future virtual PMPs should be based on evidence-based clinical guidelines, and more research is needed to explore the effectiveness of virtually delivered PMPs and each recommended component.

scholarly journals Feasibility of Screening for Frailty in Elderly Patients with Arterial Hypertension: Age Is Not a Hindrance?

Medicina ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 36-57
Author(s):  
S. N. Bel'diev ◽  
◽  
E. V. Andreeva ◽  
E. I. Berezina ◽  
I. V. Egorova ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Elderly Patients ◽  
Drug Treatment ◽  
Arterial Hypertension ◽  
Treatment Strategy ◽  
Clinical Guidelines ◽  
Critical Analysis ◽  
Geriatric Care ◽  
Evidence Based ◽  
Care Availability

The Russian clinical guidelines "Arterial hypertension in adults" (2020) contain a statement according to which elderly (≥65 years) patients should be screened for frailty using "Vozrast ne pomeha" (verbatim – "Age is not a hindrance") questionnaire, since the identification of frailty can affect drug treatment strategy and level of target blood pressure. The paper presents a critical analysis of this statement, which shows that recommendation to use "Vozrast ne pomeha" questionnaire for frailty screening is insufficiently evidence based and does not fully take into account the problem of geriatric care availability.

Clinical guidelines as a resource for evidence-based physiotherapy

2011 ◽  
pp. 135-142
Author(s):  
Rob Herbert ◽  
Gro Jamtvedt ◽  
Kåre Birger Hagen ◽  
Judy Mead
Keyword(s):  
Clinical Guidelines ◽  
Evidence Based

Mental health apps education on depression: Systematic assessment (Preprint)

2021 ◽  
Author(s):  
Laura Martinengo ◽  
Anne-Claire Stona ◽  
Lorainne Tudor Car ◽  
Jimmy Lee ◽  
Konstadina Griva ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Guidelines ◽  
Help Seeking ◽  
Support Network ◽  
Evidence Based ◽  
Educational Content ◽  
Systematic Assessment ◽  
Android Apps ◽  
Symptoms Of Depression ◽  
Health Apps

BACKGROUND Suboptimal understanding of depression and mental health disorders by the general population is an important contributor to the wide treatment gap in depression. Mental health literacy encompasses knowledge and beliefs about mental disorders and supports their recognition, management, and prevention. Besides knowledge improvement, psychoeducational interventions reduce symptoms of depression, enhance help-seeking behavior, and decrease stigma. Mental health apps often offer educational content, but the trustworthiness of included information is unclear OBJECTIVE To systematically evaluate adherence to depression clinical guidelines of the information offered by mental health apps available in major commercial app stores. METHODS A systematic assessment of the educational content about depression in apps available in Google Play and Apple’s App Store was conducted in July 2020. A systematic search for apps published or updated since January 2019 was performed using 42matters. Apps meeting inclusion criteria were downloaded and assessed using an iPhone 7 (iOS 14.0.1) and a Sony XPERIA XZs (Android 8.0.0) smartphones. The 156 questions assessment checklist comprised general characteristics of apps, appraisal of educational content and its adherence to evidence-based clinical guidelines, and technical aspects and quality assurance. Results were tabulated and reported as a narrative review, using descriptive statistics. RESULTS The app search retrieved 2,218 apps of which 58 were included in the analysis (29 Android apps and 29 iOS apps). Thirty-seven apps (64%) offered educational content within a more comprehensive depression or mental health management app. Twelve apps (21%) provided non-evidence-based information. Most apps (51/58, 88%) included up to 20/38 educational topics assessed. Common educational topics were listing symptoms of depression (52/58, 90%) and available treatments (48/58, 83%), particularly psychotherapy. Depression-associated stigma was mentioned by 38% of apps, while suicide risk was mentioned by 71% of apps, generally as one item in a list of symptoms. Forty-four (76%) apps highlighted the importance of help-seeking, and 50% of apps emphasized the importance of involving the user’s support network. Thirty apps (52%) referenced their content and ten apps (17%) included advertisements. CONCLUSIONS Information in mental health and depression apps is often brief and incomplete. One in five apps provided non-evidence-based information. Given the unmet needs and stigma associated with the disease, it is imperative that apps seize the opportunity to offer quality, evidence-based education and/or point the users to relevant resources. A multi-stakeholder consensus on a more stringent development and publication process for mental health apps is imperative.

scholarly journals Transgender adolescents and genital-alignment surgery: Is age restriction justified?

2019 ◽  
Vol 14 (2) ◽  
pp. 94-103
Author(s):  
Edmund Horowicz
Keyword(s):  
Young People ◽  
Clinical Guidelines ◽  
Gender Dysphoria ◽  
Evidence Base ◽  
Cultural Norms ◽  
Evidence Based ◽  
Professional Issues ◽  
Standards Of Evidence ◽  
Current Concerns ◽  
Evidence Based Care

In the case of controversial interventions there is a need for clinical guidelines to be founded on ‘expert opinion’ and an evidence base, in order to minimise individual clinicians making subjective decisions influenced by bias or cultural norms. This paper considers international clinical guidelines that through recommendation effectively prohibit the provision of genital-alignment surgery for competent adolescents with gender dysphoria. I argue that although the rationale for this particular guideline is based on serious concerns, these need to be better understood to allow reconsideration of this unilateral prohibitive recommendation. I do not propose that genital-alignment surgery should be prima-facia provided for any adolescent with gender dysphoria. Instead I argue that by developing our understanding of the current concerns, we can allow guidelines to incorporate a margin of clinical discretion, to allow clinicians to provide genital-alignment surgery to some adolescents, where clinically appropriate. In facilitating this we can move towards establishing a solid evidence-base. The basis of this position is that clinical guidelines and medical practice should treat these young people with the same standards of evidence-based care as others who have less controversial conditions. Whilst this paper uses English law and UK professional regulation for context, many of the ethical, legal and professional issues highlighted are applicable to other jurisdictions.

scholarly journals Establishing treatment benchmarks for mammography-screened breast cancer population based on a review of evidence-based clinical guidelines

Cancer ◽  
2008 ◽  
Vol 112 (9) ◽  
pp. 1912-1922 ◽  
Author(s):  
Geoff Delaney ◽  
Jesmin Shafiq ◽  
Genevieve Chappell ◽  
Michael Barton
Keyword(s):  
Breast Cancer ◽  
Clinical Guidelines ◽  
Population Based ◽  
Evidence Based
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