Dear Editor,
The provision of quality health services has become a major concern for policymakers and societies worldwide. The World Health Organization emphasizes that the quality of care is crucial to establishing trust in healthcare professionals. Clinical Practice Guidelines (CPGs) are scientific statements designed to assist physicians and patients in making informed decisions regarding appropriate and high-quality care for specific clinical conditions.[1] However, despite the significant cost incurred in developing and publishing numerous CPGs over the past decade, their quality varies greatly. The American Institute of Medicine has outlined eight desirable features for CPGs in a prominent report, but unfortunately, most developed guidelines do not meet these criteria.[2,3]
Experts attribute this deficiency to weaknesses in training on guideline preparation standards, a lack of specific guidance for guideline design, and the overall complexity involved in the process of developing CPGs. To address these shortcomings, the Ministry of Health has formulated guidelines design instructions, which, if followed, can effectively resolve the challenges associated with producing guidelines.[4]
The Isfahan Cardiovascular Research Institute has utilized these instructions to develop two guidelines and update one existing one. However, even with the availability of these instructions, the institute encountered difficulties during the development process. The primary challenge was the limited awareness among members of the guideline development group regarding the guideline development process. This hurdle was largely overcome by providing step-by-step training at the beginning of each meeting. Additionally, faculty members exhibited weak motivation to collaborate in the guideline development process due to various factors. These included high workloads, uncertainty about the strategy for applying and implementing CPGs, the belief that existing non-Iranian guidelines were sufficient, and shortcomings in the implementation and evaluation of developed guidelines. Other issues faced by stakeholders during guideline development included insufficient funding in this area and limited access to scientific sources and published articles due to weaknesses in existing databases within the country.
To address the current challenges in CPG development at universities, several suggestions have been proposed. These include strengthening centralized management, providing comprehensive training on the workflow of the production process and relevant instructions by the Ministry of Health, and increasing the budget allocated for producing CPGs. Implementing these solutions will facilitate the production of high-quality CPGs and alleviate the existing problems.
Financial support and sponsorship
Nil.
Conflicts of interest
Nothing to declare.
References
- 1.Kimiaeimehr F, Hosseini SM, Alimohammadzadeh K, Bahadori M, Maher A. The study of factors affecting the implementation of clinical guidelines in Iran. J Mil Med. 2019;21:300–10. doi: 10.34171/mjiri.34.122. [DOI] [PMC free article] [PubMed] [Google Scholar]
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