SPECIFIC ISSUES RELATED TO DEVELOPING, DISSEMINATING, AND IMPLEMENTING PEDIATRIC PRACTICE GUIDELINES FOR PHYSICIANS, PATIENTS, FAMILIES, AND OTHER STAKEHOLDERS
H. Bauchner et L. Simpson, SPECIFIC ISSUES RELATED TO DEVELOPING, DISSEMINATING, AND IMPLEMENTING PEDIATRIC PRACTICE GUIDELINES FOR PHYSICIANS, PATIENTS, FAMILIES, AND OTHER STAKEHOLDERS, Health services research, 33(4), 1998, pp. 1161-1177
Citations number
51
Categorie Soggetti
Heath Policy & Services","Health Care Sciences & Services
Objective. To describe ways in which medical information should be dev
eloped and disseminated, focusing on pediatric practice guidelines as
an example of one type of information. Principal Findings. The methodo
logy of guideline development is well, known and has been previously r
eviewed. Guideline development poses problems for many medical special
ties, but particularly for pediatrics, because (1) few diseases are pr
evalent, (2) only limited randomized controlled trials have been condu
cted with respect to specific diagnostic and therapeutic options, and
(3) clinicians often are dealing with patient surrogates-parents-rathe
r than with the actual patient. Patient and family involvement in guid
eline development and dissemination has been limited and may affect th
e likelihood that guidelines will be adopted and subsequently improve
child health outcomes. The science of dissemination, including guideli
nes and other information, is poorly developed. Little is known about
the most effective ways to ensure that guidelines reach clinicians and
are adopted. Finally, the effect of guidelines on child health outcom
es is itself uncertain. Recommendations, (1) Research efforts should f
ocus on guideline dissemination and adoption. (2) The effect of guidel
ine implementation on health outcomes needs to be better understood. (
3) Parents should be more involved in guideline dissemination and adop
tion.