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Clinical practice guideline adaptation methods in resource-constrained settings : four case studies from South Africa

dc.contributor.authorMcCaul, Michaelen_ZA
dc.contributor.authorErnstzen, Dawnen_ZA
dc.contributor.authorTemmingh, Henken_ZA
dc.contributor.authorDraper, Beverlyen_ZA
dc.contributor.authorGalloway, Michelleen_ZA
dc.contributor.authorKredo, Tamaraen_ZA
dc.date.accessioned2022-05-04T06:45:38Z
dc.date.available2022-05-04T06:45:38Z
dc.date.issued2020-12
dc.identifier.citationMcCaul, Michael et al. 2020. Clinical practice guideline adaptation methods in resource-constrained settings : four case studies from South Africa. BMJ Evidence-Based Medicine, 25(6):193-198, doi:10.1136/bmjebm-2019-111192en_ZA
dc.identifier.otherdoi:10.1136/bmjebm-2019-111192
dc.identifier.urihttp://hdl.handle.net/10019.1/125181
dc.descriptionCITATION: McCaul, Michael et al. 2020. Clinical practice guideline adaptation methods in resource-constrained settings : four case studies from South Africa. BMJ Evidence-Based Medicine, 25(6):193-198, doi:10.1136/bmjebm-2019-111192.en_ZA
dc.descriptionThe original publication is available at: https://ebm.bmj.com
dc.description.abstractDeveloping a clinical practice guideline (CPG) is expensive and time-consuming and therefore often unrealistic in settings with limited funding or resources. Although CPGs form the cornerstone of providing synthesised, systematic, evidence-based guidance to patients, healthcare practitioners and managers, there is no added benefit in developing new CPGs when there are accessible, good-quality, up-to-date CPGs available that can be adapted to fit local needs. Different approaches to CPG development have been proposed, including adopting, adapting or contextualising existing high-quality CPGs to make recommendations relevant to local contexts. These approaches are attractive where technical and financial resources are limited and high-quality guidance already exists. However, few examples exist to showcase such alternative approaches to CPG development. The South African Guidelines Excellence project held a workshop in 2017 to provide an opportunity for dialogue regarding different approaches to guideline development with key examples and case studies from the South African setting. Four CPGs represented the topics: mental health, health promotion, chronic musculoskeletal pain and prehospital emergency care. Each CPG used a different approach, however, using transparent, reportable methods. They included advisory groups with representation from content experts, CPG users and methodologists. They assessed CPGs and systematic reviews for adopting or adapting. Each team considered local context issues through qualitative research or stakeholder engagement. Lessons learnt include that South Africa needs fit-for-purpose guidelines and that existing appropriate, high-quality guidelines must be taken into account. Approaches for adapting guidelines are not clear globally and there are lessons to be learnt from existing descriptions of approaches from South Africa.en_ZA
dc.format.extent6 pages
dc.language.isoen_ZAen_ZA
dc.publisherBMJ Publishing
dc.subjectmental healthen_ZA
dc.subjectprimary careen_ZA
dc.subjectpublic healthen_ZA
dc.titleClinical practice guideline adaptation methods in resource-constrained settings : four case studies from South Africaen_ZA
dc.typeArticleen_ZA
dc.description.versionPublisher's version
dc.rights.holderAuthors retain copyright


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