Creating implementable clinical practice guidelines: the 2020 Focused Updates to the National Heart, Lung, and Blood Institute’s Asthma Management Guidelines
Abstract Background The 2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group provides the first new clinical practice recommendations from the National Heart, Lung, and Blood Ins...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | Implementation Science Communications |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43058-023-00417-3 |
| _version_ | 1797853774550663168 |
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| author | Susan T. Shero Neyal J. Ammary-Risch Edwin A. Lomotan Russell E. Mardon Maria Michaels |
| author_facet | Susan T. Shero Neyal J. Ammary-Risch Edwin A. Lomotan Russell E. Mardon Maria Michaels |
| author_sort | Susan T. Shero |
| collection | DOAJ |
| description | Abstract Background The 2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group provides the first new clinical practice recommendations from the National Heart, Lung, and Blood Institute (NHLBI) since the previous 2007 asthma management guidelines. Guideline implementability was a high priority for the expert panel, and many approaches were undertaken to enhance the implementability of this clinical guideline update. Within the report, specific implementation guidance sections provide expanded summaries for each recommendation to quickly assist users. The implementation guidance incorporates findings from NHLBI-sponsored focus groups conducted with people who have asthma, caregivers, and health care providers. The findings were used to identify the types of information and tools that individuals with asthma, their caregivers, and their health care providers would find most helpful; ensure that the new asthma guidelines reflect the voices of individuals with asthma and their caregivers; and identify potential barriers to uptake by individuals with asthma and their caregivers. The expert panel used a GRADE-based approach to develop evidence-to-decision tables that provided a framework for assessing the evidence and consideration of a range of contextual factors that influenced the recommendations such as desirable and undesirable effects, certainty of evidence, values, balance of effects, acceptability, feasibility, and equity. To facilitate uptake in clinical care workflow, selected recommendations were converted into structured, computer-based clinical decision support artifacts, and the new recommendations were integrated into existing treatment tables used in the 2007 asthma management guidelines, with which many users are familiar. A comprehensive approach to improve guidelines dissemination and implementation included scientific publications, patient materials, media activities, stakeholder engagement, and professional education. Conclusion We developed evidence-based clinical practice guideline updates for asthma management focused on six topic areas. The guideline development processes and implementation and dissemination activities undertaken sought to enhance implementability by focusing on intrinsic factors as described by Kastner, Gagliardi, and others to produce usable, adoptable, and adaptable guidelines. Enhanced collaboration during guideline development between authors, informaticists, and implementation scientists may facilitate the development of tools that support the application of recommendations to further improve implementability. |
| first_indexed | 2024-04-09T19:55:06Z |
| format | Article |
| id | doaj.art-4036e3b94faa431ea82c5b44f27edd36 |
| institution | Directory Open Access Journal |
| issn | 2662-2211 |
| language | English |
| last_indexed | 2024-04-09T19:55:06Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Implementation Science Communications |
| spelling | doaj.art-4036e3b94faa431ea82c5b44f27edd362023-04-03T05:28:44ZengBMCImplementation Science Communications2662-22112023-03-01411710.1186/s43058-023-00417-3Creating implementable clinical practice guidelines: the 2020 Focused Updates to the National Heart, Lung, and Blood Institute’s Asthma Management GuidelinesSusan T. Shero0Neyal J. Ammary-Risch1Edwin A. Lomotan2Russell E. MardonMaria Michaels3National Heart Lung and Blood InstituteNational Heart Lung and Blood InstituteAgency for Healthcare Research and QualityCenters for Disease Control and PreventionAbstract Background The 2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group provides the first new clinical practice recommendations from the National Heart, Lung, and Blood Institute (NHLBI) since the previous 2007 asthma management guidelines. Guideline implementability was a high priority for the expert panel, and many approaches were undertaken to enhance the implementability of this clinical guideline update. Within the report, specific implementation guidance sections provide expanded summaries for each recommendation to quickly assist users. The implementation guidance incorporates findings from NHLBI-sponsored focus groups conducted with people who have asthma, caregivers, and health care providers. The findings were used to identify the types of information and tools that individuals with asthma, their caregivers, and their health care providers would find most helpful; ensure that the new asthma guidelines reflect the voices of individuals with asthma and their caregivers; and identify potential barriers to uptake by individuals with asthma and their caregivers. The expert panel used a GRADE-based approach to develop evidence-to-decision tables that provided a framework for assessing the evidence and consideration of a range of contextual factors that influenced the recommendations such as desirable and undesirable effects, certainty of evidence, values, balance of effects, acceptability, feasibility, and equity. To facilitate uptake in clinical care workflow, selected recommendations were converted into structured, computer-based clinical decision support artifacts, and the new recommendations were integrated into existing treatment tables used in the 2007 asthma management guidelines, with which many users are familiar. A comprehensive approach to improve guidelines dissemination and implementation included scientific publications, patient materials, media activities, stakeholder engagement, and professional education. Conclusion We developed evidence-based clinical practice guideline updates for asthma management focused on six topic areas. The guideline development processes and implementation and dissemination activities undertaken sought to enhance implementability by focusing on intrinsic factors as described by Kastner, Gagliardi, and others to produce usable, adoptable, and adaptable guidelines. Enhanced collaboration during guideline development between authors, informaticists, and implementation scientists may facilitate the development of tools that support the application of recommendations to further improve implementability.https://doi.org/10.1186/s43058-023-00417-3ImplementabilityGuidelinesClinical decision supportAsthma |
| spellingShingle | Susan T. Shero Neyal J. Ammary-Risch Edwin A. Lomotan Russell E. Mardon Maria Michaels Creating implementable clinical practice guidelines: the 2020 Focused Updates to the National Heart, Lung, and Blood Institute’s Asthma Management Guidelines Implementation Science Communications Implementability Guidelines Clinical decision support Asthma |
| title | Creating implementable clinical practice guidelines: the 2020 Focused Updates to the National Heart, Lung, and Blood Institute’s Asthma Management Guidelines |
| title_full | Creating implementable clinical practice guidelines: the 2020 Focused Updates to the National Heart, Lung, and Blood Institute’s Asthma Management Guidelines |
| title_fullStr | Creating implementable clinical practice guidelines: the 2020 Focused Updates to the National Heart, Lung, and Blood Institute’s Asthma Management Guidelines |
| title_full_unstemmed | Creating implementable clinical practice guidelines: the 2020 Focused Updates to the National Heart, Lung, and Blood Institute’s Asthma Management Guidelines |
| title_short | Creating implementable clinical practice guidelines: the 2020 Focused Updates to the National Heart, Lung, and Blood Institute’s Asthma Management Guidelines |
| title_sort | creating implementable clinical practice guidelines the 2020 focused updates to the national heart lung and blood institute s asthma management guidelines |
| topic | Implementability Guidelines Clinical decision support Asthma |
| url | https://doi.org/10.1186/s43058-023-00417-3 |
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