Dissemination of Clinical Practice Guidelines to Patients and the Public

Abstract

People are seeking health information from a wide variety of sources. The comprehensive information in clinical practice guidelines (CPGs) represents an excellent source of evidence based information which should be communicated to this audience. Currently, there is little research about how to write a version of a CPG that would be easily accessible to people and more information is needed to identify barriers and supports, and potential solutions to disseminate CPGs to this audience (i.e. patients and the public).

This thesis represents a body of research consisting of four scientific papers with an overarching objective to understand and explore how CPGs and recommendations primarily developed and written for health care professionals can be disseminated to patients and the public. A CPG was developed using the rigorous methods of the GRADE approach; a randomised controlled trial was conducted to evaluate a format to disseminate synthesised evidence to patients and the public; a systematic review of the literature with a thematic and narrative synthesis of patient and public attitudes towards and awareness of CPGs was performed; and a qualitative description and content analysis of a sample of patients versions of CPGs was conducted. The studies found that people are interested in patient versions of CPGs for a variety of purposes, such as for decision making, as a tool to prepare for consultations with health care providers, and as advice for self-care management. However, barriers to their use may include lack of personalisation of information, negative attitudes towards guidelines as ways to restrict and control access to care, and lack of understanding of the recommendations and the evidence. A format to disseminate the evidence from a guideline is proposed, but future research should focus on strategies to personalise the information, to overcome the negative attitudes towards guidelines, and to communicate the recommendations and the evidence informing the recommendations.