Creating a multidisciplinary low back pain guideline: anatomy of a guideline adaptation process

Abstract

Guideline adaptation is useful when resources are limited and good-quality seed CPGs exist. The Ambassador Program successfully utilized existing stakeholder interest to create an overarching guideline that aligned guidance for LBP management across multiple primary care disciplines. Unforeseen challenges in guideline adaptation can be overcome with credible seed guidelines, a consistently applied and transparent methodology, and clear documentation of the subjective contextualization process. Multidisciplinary stakeholder input and an open, trusting relationship among all contributors will ensure that the end product is clinically meaningful.

Adapting lung cancer symptom investigation and referral guidelines for general practitioners in Australia: Reflections on the utility of the ADAPTE framework

“…The findings in this study reflect the lessons learned by a MDT of researchers, clinicians and health service providers working to produce an adapted guide in Australia and complement reported experiences from six GDGs in Canada . As suggested by Harrison and colleagues , the issues raised in these papers reflect the expectations of guideline developers who use the ADAPTE process.…”

“…The involvement of multidisciplinary experts is critical during the development and adaptation phases as such experts encourage ownership of guideline recommendations and are required to ensure that recommendations are contextually relevant . However as previously highlighted , this study found that recruiting and sustaining involvement of experts necessary to guide this work was difficult, posing a potential risk to the guideline adaptation process.…”

Adapting a large database of point of care summarized guidelines: a process description

“…Very similar barriers were identified by Harstall et al . in the evaluation of the Alberta Ambassador Project [24,29], by Chakraborty et al . [19] in Australia.…”

The updated clinical guideline development process in Estonia is an efficient method for developing evidence-based guidelines

“…The ADAPTE process describes adaptation of recommendations, external review, and adoption, endorsement, and implementation of the recommendations. Processes for guideline adaptation proposed by ADAPTE and the Alberta Ambassador Program have been recently tested in the Canadian context [11,13]. However, neither of these processes specifically address options for developing guidelines in lowresource settings, nor do they consider how to link guideline development and implementation with other strategies to improve quality of health care.…”