TY - JOUR
AU - C. Fernandes
AU - D. Campbell-Scherer
AU - A. Lofters
AU - E. Grunfeld
AU - K. Aubrey-Bassler
AU - H. Cheung
AU - K. Latko
AU - W. Tink
AU - R. Lewanczuk
AU - M. Shea-Budgell
AU - R. Heisey
AU - T. Wong
AU - H. Yang
AU - S. Walji
AU - M. Wilson
AU - E. Holmes
AU - K. Lang-Robertson
AU - C. DeLonghi
AU - D. P. Manca
A1 - 
AB - BACKGROUND: Clinical practice guidelines (CPGs) synthesize high-quality information to support evidence-based clinical practice. In primary care, numerous CPGs must be integrated to address the needs of patients with multiple risks and conditions. The BETTER program aims to improve prevention and screening for cancer and chronic disease in primary care by synthesizing CPGs into integrated, actionable recommendations. We describe the process used to harmonize high-quality cancer and chronic disease prevention and screening (CCDPS) CPGs to update the BETTER program. METHODS: A review of CPG databases, repositories, and grey literature was conducted to identify international and Canadian (national and provincial) CPGs for CCDPS in adults 40-69 years of age across 19 topic areas: cancers, cardiovascular disease, chronic obstructive pulmonary disease, diabetes, hepatitis C, obesity, osteoporosis, depression, and associated risk factors (i.e., diet, physical activity, alcohol, cannabis, drug, tobacco, and vaping/e-cigarette use). CPGs published in English between 2016 and 2021, applicable to adults, and containing CCDPS recommendations were included. Guideline quality was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool and a three-step process involving patients, health policy, content experts, primary care providers, and researchers was used to identify and synthesize recommendations. RESULTS: We identified 51 international and Canadian CPGs and 22 guidelines developed by provincial organizations that provided relevant CCDPS recommendations. Clinical recommendations were extracted and reviewed for inclusion using the following criteria: 1) pertinence to primary prevention and screening, 2) relevance to adults ages 40-69, and 3) applicability to diverse primary care settings. Recommendations were synthesized and integrated into the BETTER toolkit alongside resources to support shared decision-making and care paths for the BETTER program. CONCLUSIONS: Comprehensive care requires the ability to address a person's overall health. An approach to identify high-quality clinical guidance to comprehensively address CCDPS is described. The process used to synthesize and harmonize implementable clinical recommendations may be useful to others wanting to integrate evidence across broad content areas to provide comprehensive care. The BETTER toolkit provides resources that clearly and succinctly present a breadth of clinical evidence that providers can use to assist with implementing CCDPS guidance in primary care.
AD - Department of Family Medicine, University of Alberta, Edmonton, AB, Canada. carolina.fernandes@ualberta.ca.; Department of Family Medicine, University of Alberta, Edmonton, AB, Canada.; Office of Lifelong Learning and the Physician Learning Program, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.; Peter Gilgan Centre for Women's Cancers, Women's College Hospital, Toronto, ON, Canada.; Ontario Institute for Cancer Research, Toronto, ON, Canada.; Discipline of Family Medicine, Memorial University of Newfoundland, St. John's, NL, Canada.; Newfoundland and Labrador Centre for Health Information, St. John's, NL, Canada.; College of Physicians and Surgeons of Ontario, Toronto, ON, Canada.; Department of Family Medicine, University of Calgary, Calgary, AB, Canada.; Alberta Health Services, Alberta, AB, Canada.; Department of Medicine, University of Alberta, Edmonton, AB, Canada.; Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada.; Family and Community Medicine, Women's College Hospital, Toronto, ON, Canada.; Strategic Clinical Networks, Alberta Health Services, Calgary, AB, Canada.; Department of Family Medicine, Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada.; Discipline of Emergency Medicine, Memorial University of Newfoundland, St. John's, NL, Canada.; Canadian Cancer Society, Toronto, ON, Canada.; Centre for Effective Practice, Toronto, ON, Canada.
AN - 38711031
BT - BMC Prim Care
C5 - Education & Workforce
CP - 1
DA - May 6
DO - 10.1186/s12875-024-02388-3
DP - NLM
ET - 20240506
IS - 1
JF - BMC Prim Care
LA - eng
N2 - BACKGROUND: Clinical practice guidelines (CPGs) synthesize high-quality information to support evidence-based clinical practice. In primary care, numerous CPGs must be integrated to address the needs of patients with multiple risks and conditions. The BETTER program aims to improve prevention and screening for cancer and chronic disease in primary care by synthesizing CPGs into integrated, actionable recommendations. We describe the process used to harmonize high-quality cancer and chronic disease prevention and screening (CCDPS) CPGs to update the BETTER program. METHODS: A review of CPG databases, repositories, and grey literature was conducted to identify international and Canadian (national and provincial) CPGs for CCDPS in adults 40-69 years of age across 19 topic areas: cancers, cardiovascular disease, chronic obstructive pulmonary disease, diabetes, hepatitis C, obesity, osteoporosis, depression, and associated risk factors (i.e., diet, physical activity, alcohol, cannabis, drug, tobacco, and vaping/e-cigarette use). CPGs published in English between 2016 and 2021, applicable to adults, and containing CCDPS recommendations were included. Guideline quality was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool and a three-step process involving patients, health policy, content experts, primary care providers, and researchers was used to identify and synthesize recommendations. RESULTS: We identified 51 international and Canadian CPGs and 22 guidelines developed by provincial organizations that provided relevant CCDPS recommendations. Clinical recommendations were extracted and reviewed for inclusion using the following criteria: 1) pertinence to primary prevention and screening, 2) relevance to adults ages 40-69, and 3) applicability to diverse primary care settings. Recommendations were synthesized and integrated into the BETTER toolkit alongside resources to support shared decision-making and care paths for the BETTER program. CONCLUSIONS: Comprehensive care requires the ability to address a person's overall health. An approach to identify high-quality clinical guidance to comprehensively address CCDPS is described. The process used to synthesize and harmonize implementable clinical recommendations may be useful to others wanting to integrate evidence across broad content areas to provide comprehensive care. The BETTER toolkit provides resources that clearly and succinctly present a breadth of clinical evidence that providers can use to assist with implementing CCDPS guidance in primary care.
PY - 2024
SN - 2731-4553
SP - 153
ST - Harmonization of clinical practice guidelines for primary prevention and screening: actionable recommendations and resources for primary care
T1 - Harmonization of clinical practice guidelines for primary prevention and screening: actionable recommendations and resources for primary care
T2 - BMC Prim Care
TI - Harmonization of clinical practice guidelines for primary prevention and screening: actionable recommendations and resources for primary care
U1 - Education & Workforce
U3 - 10.1186/s12875-024-02388-3
VL - 25
VO - 2731-4553
Y1 - 2024
ER -