Best practice for the selection, design and implementation of UK Kidney Association guidelines: a modified Delphi consensus approach.


Journal

BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874

Informations de publication

Date de publication:
18 Jun 2024
Historique:
medline: 19 6 2024
pubmed: 19 6 2024
entrez: 18 6 2024
Statut: epublish

Résumé

Despite research into how to effectively implement evidence-based recommendations into clinical practice, a lack of standardisation in the commissioning and development of clinical practice guidelines can lead to inconsistencies and gaps in implementation. This research aimed to ascertain how topics in kidney care worthy of guideline development within the UK should be chosen, prioritised, designed and implemented. Following a modified Delphi methodology, a multi-disciplinary panel of experts in kidney healthcare from across the UK developed 35 statements on the issues surrounding the selection, development and implementation of nephrology guidelines. Consensus with these statements was determined by agreement using an online survey; the consensus threshold was defined as 75% agreement. 419 responses were received. Of the 364 healthcare practitioners (HCPs), the majority had over 20 years of experience in their role (n=123) and most respondents were nephrologists (n=95). Of the 55 non-clinical respondents, the majority were people with kidney disease (n=41) and the rest were their carers or family. Participants were from across England, Northern Ireland, Scotland and Wales. Consensus between HCPs was achieved in 32/35 statements, with 28 statements reaching ≥90% agreement. Consensus between patients and patient representatives was achieved across all 20 statements, with 13/20 reaching ≥90% agreement. The current results have provided the basis for six recommendations to improve the selection, design and implementation of guidelines. Actioning these recommendations will help improve the accessibility of, and engagement with, clinical guidelines, contributing to the continuing development of best practice in UK kidney care.

Sections du résumé

BACKGROUND BACKGROUND
Despite research into how to effectively implement evidence-based recommendations into clinical practice, a lack of standardisation in the commissioning and development of clinical practice guidelines can lead to inconsistencies and gaps in implementation. This research aimed to ascertain how topics in kidney care worthy of guideline development within the UK should be chosen, prioritised, designed and implemented.
METHODS METHODS
Following a modified Delphi methodology, a multi-disciplinary panel of experts in kidney healthcare from across the UK developed 35 statements on the issues surrounding the selection, development and implementation of nephrology guidelines. Consensus with these statements was determined by agreement using an online survey; the consensus threshold was defined as 75% agreement.
RESULTS RESULTS
419 responses were received. Of the 364 healthcare practitioners (HCPs), the majority had over 20 years of experience in their role (n=123) and most respondents were nephrologists (n=95). Of the 55 non-clinical respondents, the majority were people with kidney disease (n=41) and the rest were their carers or family. Participants were from across England, Northern Ireland, Scotland and Wales. Consensus between HCPs was achieved in 32/35 statements, with 28 statements reaching ≥90% agreement. Consensus between patients and patient representatives was achieved across all 20 statements, with 13/20 reaching ≥90% agreement.
CONCLUSIONS CONCLUSIONS
The current results have provided the basis for six recommendations to improve the selection, design and implementation of guidelines. Actioning these recommendations will help improve the accessibility of, and engagement with, clinical guidelines, contributing to the continuing development of best practice in UK kidney care.

Identifiants

pubmed: 38890135
pii: bmjopen-2024-085723
doi: 10.1136/bmjopen-2024-085723
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e085723

Informations de copyright

© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

James O Burton (JO)

Department of Cardiovascular Sciences, University of Leicester, Leicester, UK jb343@le.ac.uk.
John Wall's Renal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK.

Joseph Chilcot (J)

Department of Psychology, King's College London, London, UK.

Katie Fielding (K)

Department of Medicine for the Elderly, Derby Teaching Hospitals NHS Foundation Trust, Derby, UK.

Andrew H Frankel (AH)

Imperial College London, London, UK.

Niraj Lakhani (N)

The Willows Health Academy, Leicester, UK.

Pam Nye (P)

UK Kidney Association, Bristol, UK.

Kathrine Parker (K)

Manchester Institute of Nephrology and Transplantation, Manchester, UK.
Manchester Academic Health Science Centre, Manchester, UK.

William Priestman (W)

Heath Lane Surgery, Leicester, UK.

Fiona Willingham (F)

Social Work and Sport, University of Central Lancashire, Preston, UK.

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