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.reuma.2014.01.010

Cited by 9 publications

(10 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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“…All eight studies included GPs while single studies also included practice nurses, pharmacists and physical therapists. The studies were conducted in a mix of urban and rural primary care settings in Australia (two studies) 24,28 , France (two studies) 23,26 , United Kingdom (two studies) 29,30 , Germany 27 and Mexico 25 . The main study details are provided in Table I with additional details provided in the Supplementary File.…”

Section: Included Articlesmentioning

confidence: 99%

“…Some additional barriers were identified by primary article authors but were not found to be themes across multiple studies. First, system-related barriers to recommended practice were identified as limitations to guideline implementation in Mexico 25 . Problems existed around availability of drugs, allied health professionals and other equipment, time constraints and difficulties with referring to specialists.…”

Section: Other Reported Barriers or Enablers (Text Box 5)mentioning

confidence: 99%

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A systematic review and evidence synthesis of qualitative studies to identify primary care clinicians' barriers and enablers to the management of osteoarthritis

Egerton

Diamond

Buchbinder

et al. 2017

Osteoarthritis and Cartilage

140

186

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“…Therefore, we need to establish guidelines for the diagnosis of OA in the primary care setting, taking into account barriers to implementing the guidelines as well as possible solutions to overcome these barriers [21–23]. Surprisingly, the OA scientific community had developed several guidelines for OA treatment before establishing clear recommendations for OA diagnosis.…”

Section: Introductionmentioning

confidence: 99%

A new decision tree for diagnosis of osteoarthritis in primary care: international consensus of experts

et al. 2018

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Background and aims Although osteoarthritis (OA) is managed mainly in primary care, general practitioners (GPs) are not always trained in its diagnosis, which leads to diagnostic delays, unnecessary resource utilization, and suboptimal patient outcomes. Methods To address this situation, an International Rheumatologic Board (IRB) of 8 experts from 3 continents developed guidelines for the diagnosis of OA in primary care. The focus was three major topologies: hip, knee, and hand/finger OA. The IRB used American College of Rheumatology diagnostic criteria. Results Care pathways based on clinical and radiological findings were developed to identify intervention thresholds for GPs/specialists. To optimize usefulness in the primary care setting, the guidelines were formatted as an uncomplicated, but comprehensive one-page decision tree for each topology, highlighting key aspects of the evaluation process and incorporating red flags. In a two-phase validation stage, the draft guidelines were evaluated by rheumatologists and GPs for project execution, content and perceived benefit. The strength of the guidelines lies in their user-friendly diagram and potential for broad application. Such guidelines will allow GPs to make an easy but definite diagnosis of OA and offer clear guidance about situations requiring an expert opinion. The guidelines have potential to improve patient outcomes and reduce the number of unnecessary procedures. Discussion and conclusions This project demonstrated the feasibility of developing easy-to-use and effective visual decision trees to facilitate the diagnosis and management of OA of the hip, knee and hand/finger in primary care. The next step should be to conduct a large impact study of implementation of these recommendations in the diagnostic management of OA in general practice in different areas.

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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 9 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

A systematic review and evidence synthesis of qualitative studies to identify primary care clinicians' barriers and enablers to the management of osteoarthritis

A new decision tree for diagnosis of osteoarthritis in primary care: international consensus of experts

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