The majority of clinical practice guidelines on osteoporosis ignore patients' voices



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The researchers reviewed the clinical practice guidelines on osteoporosis and found that less than 40% of them mentioned their beliefs, values, or preferences (BVP).

Clinical Practice Guidelines are designed to help health professionals achieve the best possible outcomes for their patients by providing evidence-based care recommendations.

In this review, published by the journal International osteoporosis, only 27 of the 70 recommendations badyzed by the researchers included the patient's BVP mention. The review included guidelines from Australia, Canada, Germany, India, Italy, Scotland, South Africa, Spain, the United Kingdom and the United States.

Guidelines that included BVPs most often refer to patients' preferences for one drug over another, said lead author Dr. Joanna Sale, clinical epidemiologist and scientist at Li Ka Shing Institute of Knowledge. from St. Michael's Hospital in Toronto.

This finding may reflect the ability of pharmaceutical companies to influence these guidelines on the experience of patients themselves.

"The choice of the drug does not seem to reflect the personal views of people with bone health problems, but it seems to reflect the pharmaceutical companies' agenda and / or the financial constraints of the individual or the patient. health care system, rather than health, "said Dr. Sale.

"If patients do not see themselves in the guidelines and recommendations of their clinicians, and if their health beliefs do not match their understanding of what is needed to improve their bone health, they will be less likely to follow the advice.It's just natural. "

Among the guidelines that referred to BVP, they most often considered that patient considerations were important, but these statements were generally not supported by evidence. Sale also noted that references to preferences were much more prominent in the guidelines than values ​​and beliefs.

"Preferences are easier to express than values ​​and beliefs.It is easy to know if patients want to take their medications once a week or every six months, and if they are willing to take them in the morning but must then wait It is more difficult to measure directly and accurately if, for example, they attach importance to the prevention of fractures or they do not believe that they are likely to suffer a future fracture, "said Dr. Sale.

"Qualitative research on patients' experiences and perceptions would help us learn more about values ​​and beliefs."

Dr. Sale hopes ultimately that BVP becomes an essential part of all clinical practice guidelines.

"Beliefs, values ​​and preferences are supposed to be a fundamental part of the guidelines," said Dr. Sale.

"Over time, with the inclusion of more BVP, we could see changes in values ​​and beliefs to support truly informed preferences and better partnerships between patients and clinicians."

Source:

http://www.stmichaelshospital.com/

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