Review of an international pilot project to adapt the Canadian Adult Obesity Clinical Practice Guideline.

Background

The evidence-based Canadian Adult Obesity Clinical Practice Guideline (CPG) released in August 2020 were developed through a systematic literature review and patient-oriented research process. This CPG is considered a paradigm shift for obesity care as it introduced a new obesity definition that is based on health not body size, incorporates lived experiences of people affected by obesity, and addresses the pervasive weight bias and stigma that patients face in healthcare systems. The purpose of this pilot project was to assess the feasibility of adapting the Canadian CPG in Chile and Ireland.

Methods

An International Clinical Practice Guideline Adaptation Committee was established to oversee the project. The project was conducted through four interrelated phases: 1) planning and preparation; 2) pilot project application process; 3) adaptation; and 4) launch, dissemination, and implementation. Ireland used the GRADE-ADAPTE framework and Chile used the GRADE-ADOLOPMENT approach.

Results

Chile and Ireland developed their adapted guidelines in one third of the time it took to develop the Canadian guidelines. In Ireland, 18 chapters, which underpin the 80 key recommendations, were contextually adapted. Chile adopted 18 chapters and 76 recommendations, adapted one recommendation, and developed 12 new recommendations.
.

Conclusion

The pilot project demonstrated it is feasible to adapt the Canadian CPG for use in other countries with different healthcare systems, languages, and cultural contexts, while retaining the Canadian CPG's key principles and values such as the treatment of obesity as a chronic disease, adoption of new clinical assessment approaches that go beyond anthropometric measurements, elimination of weight bias and stigma, shifting obesity care outcomes to improved health and well-being rather than weight loss alone, and the use of patient-centred, collaborative and shared-decision clinical care approaches.

Informations de copyright

© 2023 The Authors.

Déclaration de conflit d'intérêts

XRS was contracted to coordinate the international guideline adaptation project by Obesity Canada and the European Association for the Study of Obesity. MSC was contracted as a research assistant by Obesity Canada for the duration of the pilot project. CB reports backfill time payment from the Association for the Study of Obesity on the island of Ireland to her employer at St Columcille's Hospital while acting as project coordinator for the pilot project in Ireland. YP reports backfill time payment from the Sociedad Chilena de Cirugía Bariátrica y Metabólica and Obesity Canada while acting as project coordinator for the pilot project in Chile. BH was contracted to coordinate communications activities for the guideline adaptation project by Obesity Canada and the European Association for the Study of Obesity. He also provided writing, editing, and proof-reading assistance for this manuscript. MF was the Scientific Director of Obesity Canada (unpaid) and the Chair of the Canadian Guideline Adaptation Committee (unpaid) for the duration of this project. SW, DCS, MV, JB, SDP, and AMS were unpaid members of the Canadian Guideline Adaptation Committee. EW is an employee of the European Association for the Study of Obesity. IP and NP are employees of Obesity Canada.