Barriers to implementing the “2008 Mexican Clinical Practice Guideline recommendations for the management of hip and knee osteoarthritis” in primary healthcare practice

Loyola‐Sánchez, Adalberto; Richardson, Julie; Peláez‐Ballestas, Ingris; Sánchez, José Guadalupe; González, Martha Alicia; Sánchez-Cruz, Juan Francisco; Jiménez-Báez, María Valeria; Nolasco-Alonso, Nancy; Alvarado, Idolina; Rodríguez-Amado, Jacqueline; Álvarez-Nemegyei, José; Wilson, Mike G.

doi:10.1016/j.reumae.2014.01.013

Cited by 2 publications

(2 citation statements)

References 25 publications

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“…The addition of GLIA at the end of the adaptation process was considered by the GAG as an improvement to the ADAPTE. Several studies have used GLIA either for testing the implementability or as a part of the development process of CPGs . Each single recommendation was executable, decidable, flexible, and valid.…”

Section: Discussionmentioning

confidence: 99%

Assessment of implementability of an adapted clinical practice guideline for surgical antimicrobial prophylaxis at a tertiary care university hospital

Altokhais

Al-Obaid

Kattan

et al. 2016

Evaluation Clinical Practice

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Rationale, aims and objectives Surgical site infections are the most common healthcare‐associated infections. Appropriate surgical antimicrobial prophylaxis (SAP), which is an integral part of surgical site infection SSI prevention, is one of the major preventable risks to surgical patient safety. Several clinical practice guidelines (CPGs) for SAP have been published. The aim of this study was to adapt a CPG for SAP and to assess its implementability. Methods The methodology was based on two validated tools for CPGs, namely, the ADAPTE and the Guideline Implementability Appraisal (GLIA). Results The ADAPTE CPG adaptation process methodology was utilized to produce an adapted CPG for SAP based on the American Society of Health System Pharmacists 2013 CPG. The finalized CPG was then assessed to identify any possible intrinsic barriers for implementation. Conclusions In conclusion, the ADAPTE tool is a practical and successful tool for production of CPGs. The GLIA tool is useful for assessing and preparing the finalized adapted CPG for the transition from the production stage to the implementation stage. GLIA could be added to the ADAPTE process either as a final step or to check the draft of the CPG before finalization.

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Section: Discussionmentioning

confidence: 99%

Assessment of implementability of an adapted clinical practice guideline for surgical antimicrobial prophylaxis at a tertiary care university hospital

Altokhais

Al-Obaid

Kattan

et al. 2016

Evaluation Clinical Practice

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“…We found variability in the degree to which treatment guidelines influenced physicians' decisions to use IA therapy. Two other qualitative studies also identified varying adherence to OA treatment guidelines and delved into potential barriers to implementation (12,15). Lastly, a study of general practitioners identified (as we did in our study) that gaps in insurance coverage pose a barrier to prescribing more costly treatment (16).…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing Physician Recommendation for Intraarticular Therapies in Osteoarthritis: Results From a Qualitative Study

MacFarlane

Williams

Lenhard

et al. 2022

Arthritis Care & Research

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Objective Several current and many emerging osteoarthritis (OA) treatments are intraarticular (IA) injections; however, little is known about physicians' perceptions and beliefs regarding IA injections or their considerations when deciding whether to recommend them to patients. We aimed to investigate physician‐perceived benefits and drawbacks of offering IA injections. Methods We conducted individual interviews with orthopedic surgeons, rheumatologists, and physiatrists who treat patients with knee OA. We conducted a thematic analysis to identify factors that physicians weigh when making IA injection recommendations. Results We interviewed 18 physicians from academic and community practices. We identified the following 4 categories of themes that influenced providers' recommendations to their patients regarding injections: 1) the physician's knowledge, beliefs, and concerns, including their propensity to rely on guidelines versus clinical experience, and understanding of the efficacy and risks associated with injectables, such as possible cartilage damage; 2) the characteristics of the injectable product, such as ease or number of administrations needed; 3) the individual patient‐specific factors, including OA severity, comorbidities, and patient preference for and expectations of specific IA injections; and 4) the financial and administrative factors, including insurance coverage and out‐of‐pocket costs. Conclusion Physicians factor the uncertain efficacy of injectable treatments and the need to manage patient expectations into their decision to offer IA therapies. Some providers relied on evidence and guidelines while others were swayed more by clinical experience. High out‐of‐pocket costs were seen as a barrier to use. These findings may help in the delivery of IA injections for OA and in the development of injectable products.

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Barriers to implementing the “2008 Mexican Clinical Practice Guideline recommendations for the management of hip and knee osteoarthritis” in primary healthcare practice

Cited by 2 publications

References 25 publications

Assessment of implementability of an adapted clinical practice guideline for surgical antimicrobial prophylaxis at a tertiary care university hospital

Assessment of implementability of an adapted clinical practice guideline for surgical antimicrobial prophylaxis at a tertiary care university hospital

Factors Influencing Physician Recommendation for Intraarticular Therapies in Osteoarthritis: Results From a Qualitative Study

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