Original Title: Desarrollo de herramientas de ayuda para la toma de decisiones compartida derivadas de las recomendaciones de las guías de práctica clínica

Authors' objectives: The general objective of this methodological manual is to define a protocol for integrating patients' preferences into the shared decision-making process based on CPGs and establishing a collaborative development of CPGs and DAs. The specific objectives are: A) Systematic review of the existing literature on the description of a strategy and / or methodology linking the development of the DAs to the recommendations of the CPGs and concrete experiences of the collaborative development of CPG and DAs. B) Qualitative study to identify concrete experiences on strategies to link the development of DAs to CPG recommendations. C) To define and agree the basis for developing a collaborative strategy for the development of CPG and HATD, taking into account the results of the systematic review and the qualitative study.

Authors' results and conclusions: RESULTS: A total of 1412 references were found in the electronic databases until June 2016, and 1239 were considered after the elimination of duplicates. Finally, a total of 40 systematic reviews were included. To these references are added 10 additional references that have been recommended by some experts in the area. From the synthesis of the included references, experts’ contributions and from the qualitative study, some key aspects and instruments were extracted to favor the incorporation of the perspective and preferences of the patient and to promote their participation in the decision making process. Different strategies and proposals were also identified to link the DAs to the recommendations developed with the GRADE system and to favor the SDM process, as well as some programs to implement the SDM model in clinical practice, the experiences and proposals of CPG, and tools for linking CPGs and DAs, among other concrete experiences of some research groups. Finally, a reference strategy is proposed for the development of DAs derived from the recommendations of the CPGs based on the experience of the SHARE-IT project. The availability of some instruments, procedures and strategies linking CPGs and DAs in other European countries have allowed the identification of some concrete guidelines that could favor the implementation of the SDM model in clinical practice. CONCLUSIONS: The development of DAs linked to the recommendations of the CPG based on the GRADE system favors the SDM process in clinical practice. It is concluded that the creation of a joint protocol for the integration of patients' values and preferences into the CPG-based decision-making process, establishing a collaborative development of CPGs and DAs, could be more efficient in sharing the same scientific evidence. It could also favor the implementation in clinical practice of CPGs and DAs. The development of DAs derived directly from the recommendations of the CPG, through the GRADE system, could improve the SDM process at the clinical encounter. The semi-automatic production of the interactive summaries of the scientific evidence in different formats and the obtaining of the recommendations from the evidence would allow to identify the conditional recommendations susceptible of becoming DAs that favor the process of SDM. The automated production of DAs, from CPG in electronic format in which CPGs can be displayed, summaries of scientific evidence and DAs in a wide range of electronic devices could facilitate their implementation in clinical practice.

Authors' methods: The databases Medline and Premedline (OvidSP), Embase (Elsevier), Cinahl (EBSCOhost), PsycINFO (EBSCOhost) and Cochrane (Wiley Online Library) were consulted to carry out a systematic review of the literature where studies with all designs, manuals, CPG, web pages or portals describing a strategy and/or methodology linking the development of DAs to CPG recommendations and studies describing a specific DAs development experience based on the recommendations of the CPGs, were included. Two reviewers performed the entire selection process of studies and in case of doubt or disagreement between them a third reviewer was consulted. In addition, experts in the field of CPG and DAs have been contacted and a qualitative study has been carried out to explore the perceptions of the relevant actors on the methodological aspects necessary to integrate the values and preferences of the patients in the process of decision-making based on CPGs and for the collaborative development of CPGs and DAs.

Project Status: Completed

Year Published: 2017

URL for published report: https://sescs.es/desarrollo-de-herramientas-de-ayuda-para-la-toma-de-decisiones-compartida-derivadas-de-las-recomendaciones-de-las-gpc/

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

Organisation Name: Canary Health Service

Contact Address: Dirección del Servicio. Servicio Canario de la Salud, Camino Candelaria 44, 1ª planta, 38109 El Rosario, Santa Cruz de Tenerife

Contact Name: sescs@sescs.es

Contact Email: sescs@sescs.es