ITEM VIEW

An innovative method for clinical practice guideline contextualisation for chronic musculoskeletal pain in the South African context

dc.contributor.authorErnstzen, D. V.en_ZA
dc.contributor.authorHillier, S. L.en_ZA
dc.contributor.authorLouw, Q. A.en_ZA
dc.date.accessioned2019-07-08T06:57:54Z
dc.date.available2019-07-08T06:57:54Z
dc.date.issued2019-06-28
dc.identifier.citationErnstzen, D. V., Hillier, S. L. & Louw, Q. A. 2019. An innovative method for clinical practice guideline contextualisation for chronic musculoskeletal pain in the South African context. BMC Medical Research Methodology, 19:134, doi:10.1186/s12874-019-0771-3
dc.identifier.issn1471-2288 (online)
dc.identifier.otherdoi:10.1186/s12874-019-0771-3
dc.identifier.urihttp://hdl.handle.net/10019.1/106306
dc.descriptionCITATION: Ernstzen, D. V., Hillier, S. L. & Louw, Q. A. 2019. An innovative method for clinical practice guideline contextualisation for chronic musculoskeletal pain in the South African context. BMC Medical Research Methodology, 19:134, doi:10.1186/s12874-019-0771-3.
dc.descriptionThe original publication is available at https://bmcmedresmethodol.biomedcentral.com
dc.description.abstractBackground: Clinical guidelines produced in developed nations may not be appropriate in resource-constrained environments, due to differences in cultural, societal, economic and policy contexts. The purpose of this article is to describe an innovative and resource-efficient method to develop a clinical practice guideline (CPG), using the CPG contextualisation approach. Methods: The four phased contextualisation framework was applied to produce a contextualised, multidisciplinary CPG for the primary health care of adults with chronic musculoskeletal pain (CMSP) in the South African context. The four phases were: a contextual analysis, evidence synthesis, contextual integration and external evaluation. Qualitative methodology was used to investigate context factors influencing health care in this environment. A systematic review was conducted to identify current, high-quality CPGs on the topic, and to synthesise a core set of clinical recommendations from the CPGs. Consensus methods were used to integrate context information with recommendations. A multidisciplinary panel of local experts authenticated and contextualised recommendations. The resultant CPG was externally reviewed using a survey. Results: The results from the contextual analysis phase indicated a wide range of contextual factors that could influence the applicability and implementability of the recommendations, including: the personal characteristics of the patient and clinician, social and environmental circumstances, healthcare interventions available, and healthcare system factors. During phase two, six existent high quality CPGs were identified and a core set of multidisciplinary recommendations were sourced from them. The contextual integration phase produced the validated recommendations, accompanied by its underpinning body of evidence and context specific information. The outcome of phase four (external review) was that the recommendations were confirmed as relevant for the intended setting. Conclusion: CPG contextualisation was found to be a practical approach to develop a contextualised multidisciplinary CPG for the primary health care of adults with CMSP in a South African setting. The contextualisation approach enhanced the integration of multiple stakeholder perspectives and highlighted the importance of considering clinical, social and economic complexities during CPG development. Attention to contextual information is advocated to enhance the uptake of CPG recommendations, particularly in resource constrained settings.en
dc.description.urihttps://bmcmedresmethodol.biomedcentral.com/articles/10.1186/s12874-019-0771-3
dc.format.extent12 pages
dc.language.isoen_ZAen_ZA
dc.publisherBMC (part of Springer Nature)
dc.subjectMusculoskeletal system -- Wounds and injuries
dc.subjectMusculoskeletal system -- Diseasesen_ZA
dc.subjectMedical protocols -- South Africaen_ZA
dc.subjectClinical medicine -- Practice -- South Africaen_ZA
dc.titleAn innovative method for clinical practice guideline contextualisation for chronic musculoskeletal pain in the South African contexten_ZA
dc.typeArticle
dc.date.updated2019-06-30T03:28:37Z
dc.description.versionPublisher's version
dc.rights.holderAuthors retain copyright


Files in this item

Thumbnail
Thumbnail

This item appears in the following Collection(s)

ITEM VIEW