Awareness, use and perception of patient versions of clinical practice guidelines - a national cross-sectional survey among patients with a cancer diagnosis and healthcare providers.


Journal

BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677

Informations de publication

Date de publication:
09 Oct 2024
Historique:
received: 21 12 2023
accepted: 09 09 2024
medline: 10 10 2024
pubmed: 10 10 2024
entrez: 9 10 2024
Statut: epublish

Résumé

To investigate awareness, use, and perceptions of the patient guidelines (PGs) of the German Guideline Program in Oncology (GGPO) and to explore general preferences regarding cancer information among patients and healthcare providers (HCPs). Two cross-sectional surveys among patients with cancer (November 2020-May 2021) and among HCPs (April -June 2021) were set up as anonymised, self-administered, semi-structured online surveys, including open-ended questions. Data were analysed with descriptive statistics and qualitative thematic analysis. Patients were recruited from national self-help organisations and certified cancer centres located all over Germany. HCPs were recruited from cancer centres, scientific medical societies and guideline groups. Of 816 participating patients, 45% were aware of the GGPO-PGs, while 55% of the 455 participating HCPs were aware of them. Of those aware of the GGPO-PGs, 65% of patients and 86% of HCPs perceived them as helpful, while 95% in both groups saw them as comprehensive. Seventy-five percent of patients and 85% of HCPs were satisfied with the GGPO-PGs, 22%/13% were partially satisfied, and 3%/2% were rather/not at all satisfied. In addition to self-help organisations, physicians and hospitals were perceived as central in distributing the GGPO-PGs. More patients (78%) than HCPs (56%) stated a preference for detailed information, although the wish for concise information - e.g. decision aids - was concurrently expressed by the majority of all participants. Thematic analysis showed that up-to-dateness, trustworthiness, and supportive messaging are important properties for PGs. HCPs found the GGPO-PGs helpful, but awareness was low, which suggests that dissemination should be improved. This is also true for patients; however, further research needs to be done to increase the helpfulness of PGs for patients. Oncological PGs seem to be needed in different formats according to patients' situational needs. Theory-driven research should investigate how to best frame patient information in a supportive way.

Sections du résumé

BACKGROUND BACKGROUND
To investigate awareness, use, and perceptions of the patient guidelines (PGs) of the German Guideline Program in Oncology (GGPO) and to explore general preferences regarding cancer information among patients and healthcare providers (HCPs).
METHODS METHODS
Two cross-sectional surveys among patients with cancer (November 2020-May 2021) and among HCPs (April -June 2021) were set up as anonymised, self-administered, semi-structured online surveys, including open-ended questions. Data were analysed with descriptive statistics and qualitative thematic analysis. Patients were recruited from national self-help organisations and certified cancer centres located all over Germany. HCPs were recruited from cancer centres, scientific medical societies and guideline groups.
RESULTS RESULTS
Of 816 participating patients, 45% were aware of the GGPO-PGs, while 55% of the 455 participating HCPs were aware of them. Of those aware of the GGPO-PGs, 65% of patients and 86% of HCPs perceived them as helpful, while 95% in both groups saw them as comprehensive. Seventy-five percent of patients and 85% of HCPs were satisfied with the GGPO-PGs, 22%/13% were partially satisfied, and 3%/2% were rather/not at all satisfied. In addition to self-help organisations, physicians and hospitals were perceived as central in distributing the GGPO-PGs. More patients (78%) than HCPs (56%) stated a preference for detailed information, although the wish for concise information - e.g. decision aids - was concurrently expressed by the majority of all participants. Thematic analysis showed that up-to-dateness, trustworthiness, and supportive messaging are important properties for PGs.
CONCLUSIONS CONCLUSIONS
HCPs found the GGPO-PGs helpful, but awareness was low, which suggests that dissemination should be improved. This is also true for patients; however, further research needs to be done to increase the helpfulness of PGs for patients. Oncological PGs seem to be needed in different formats according to patients' situational needs. Theory-driven research should investigate how to best frame patient information in a supportive way.

Identifiants

pubmed: 39385177
doi: 10.1186/s12913-024-11563-2
pii: 10.1186/s12913-024-11563-2
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1211

Informations de copyright

© 2024. The Author(s).

Références

Blodt S, Kaiser M, Adam Y, Adami S, Schultze M, Muller-Nordhorn J, et al. Understanding the role of health information in patients’ experiences: secondary analysis of qualitative narrative interviews with people diagnosed with cancer in Germany. BMJ Open. 2018;8(3):e019576.
doi: 10.1136/bmjopen-2017-019576 pubmed: 29530909 pmcid: 5857676
Robert Koch-Institute. Krebs in Deutschland für 2017/2018: Zentrum für Krebsregisterdaten Gesellschaft der epidemiologischen Krebsregister in Deutschland e.V.; 2021 [13. :[Available from: https://www.krebsdaten.de/Krebs/DE/Content/Publikationen/Krebs_in_Deutschland/kid_2021/krebs_in_deutschland_2021.pdf?__blob=publicationFile .
Ministry of Health. Ziele des Nationalen Krebsplans - NKP 2008. Available from: https://www.bundesgesundheitsministerium.de/themen/praevention/nationaler-krebsplan/handlungsfelder/ziele-des-nationalen-krebsplans.html . Cited 2022 August.
German Cancer Society e.V. . Certification 2022. Available from: https://www.krebsgesellschaft.de/gcs/german-cancer-society/certification.html . Cited 2022 August.
Institute of Medicine. Clinical practice guidelines we can trust. Graham R, Mancher M, Wolman DM, Greenfield S, Steinberg E, editors. Washington, DC: The National Academies Press; 2011:290.
Bundesministerium für Gesundheit. Gesetz zur Verbesserung der Rechte von Patientinnen und Patienten Bonn. 2013. Cited 2013 Februar 20.
Ärztliches Zentrum für Qualität in der Medizin (ÄZQ), Office des Leitlinienprogramms Onkologie (OL), AWMF-Institut für Medizinisches Wissensmanagement (AWMF-IMWi). Erstellung von Patientenleitlinien zu S3-Leitlinien/NVL im Rahmen der Leitlinienprogramme2016 Letzter Zugriff am 02.09.2020; Beta-Version 2. Available from: www.patienten-information.de/patientenleitlinien .
Graham K, Schaefer C, Santesso N. G-I-N PUBLIC Toolkit: Patient and Public Involvement in Guidelines 2015 [Guidelines International Network (GIN):[Available from: https://g-i-n.net/chapter/patient-information/ .
National Institute for Health and Care Excellence (NICE). Research recommendations process and methods guide. 2015. Available from: https://www.nice.org.uk/Media/Default/About/what-we-do/Research-and-development/Research-Recommendation-Process-and-Methods-Guide-2015.pdf .
American Society of Clinical Oncology. ASCO answers patient education materials: ASCO. 2022. Available from: https://www.cancer.net/about-us/asco-answers-patient-education-materials .
Treweek S, Oxman AD, Alderson P, Bossuyt PM, Brandt L, Brozek J, et al. Developing and Evaluating Communication strategies to support Informed Decisions and practice based on Evidence (DECIDE): protocol and preliminary results. Implementation Sci. 2013;8:6.
doi: 10.1186/1748-5908-8-6
Loudon K, Santesso N, Callaghan M, Thornton J, Harbour J, Graham K, et al. Patient and public attitudes to and awareness of clinical practice guidelines: a systematic review with thematic and narrative syntheses. BMC Health Serv Res. 2014;14:321.
doi: 10.1186/1472-6963-14-321 pubmed: 25064372 pmcid: 4119247
Fearns N, Kelly J, Callaghan M, Graham K, Loudon K, Harbour R, et al. What do patients and the public know about clinical practice guidelines and what do they want from them? A qualitative study. BMC Health Serv Res. 2016;16:74.
doi: 10.1186/s12913-016-1319-4 pubmed: 27121606 pmcid: 4847193
Santesso N, Morgano GP, Jack SM, Haynes RB, Hill S, Treweek S, et al. Dissemination of clinical practice guidelines: a content analysis of patient versions. Med Decis Making. 2016;36(6):692–702.
doi: 10.1177/0272989X16644427 pubmed: 27091380
McMaster University and Evidence Prime Inc. GRADEpro. 2019. Available from: https://gradepro.org/ .
MAGIC Evidence Ecosystem Foundation, Oslo, Norway. Available from: https://app.magicapp.org/#/guidelines .
Krebshilfe. Blaue ratgeber. 2024.
Keinki C, Seilacher E, Ebel M, Ruetters D, Kessler I, Stellamanns J, et al. Information needs of cancer patients and perception of impact of the disease, of self-efficacy, and locus of control. J Cancer Educ. 2016;31(3):610–6.
doi: 10.1007/s13187-015-0860-x pubmed: 25994358
Patient Guidelines of the German Guidelines Program in Oncology (GGPO-PG): German guidelines program in oncology; 2024. Available from: https://www.leitlinienprogramm-onkologie.de/patientenleitlinien/uebersicht .
Schaefer C, Zowalla R, Wiesner M, Siegert S, Bothe L, Follmann M. Patient guidelines in oncology: objectives, procedures and first experiences with this format. Z Evid Fortbild Qual Gesundhwes. 2015;109(6):445–51.
doi: 10.1016/j.zefq.2015.09.013 pubmed: 26474649
Becker M, Buhn S, Meyer N, Blodt S, Carl G, Follmann M, et al. Investigating the role and applicability of patient versions of guidelines in oncology and deriving recommendations for the development, dissemination and implementation of patient versions in Germany: protocol for multiphase study. BMJ Open. 2022;12(3):e059040.
doi: 10.1136/bmjopen-2021-059040 pubmed: 35296489 pmcid: 8928290
Heiligenhaus A, Michels H, Schumacher C, Kopp I, Neudorf U, Niehues T, et al. Evidence-based, interdisciplinary guidelines for anti-inflammatory treatment of uveitis associated with juvenile idiopathic arthritis. Rheumatol Int. 2012;32(5):1121–33.
doi: 10.1007/s00296-011-2126-1 pubmed: 22083610
Braun V, Clarke V. Using thematic analysis in psychology. Quali Res Psychol. 2006;3:77–101.
doi: 10.1191/1478088706qp063oa
Collins N. Strategic marketing plans. Minneapolis: Walden University; 2014.
Graham K, Schaefer C, Santesso N. G-I-N PUBLIC Toolkit: patient and public involvement in guidelines- dissemination. 2015. Available from: https://g-i-n.net/toolkit/dissemination-of-guidelines/ .
Akl E, Meerpohl J, Elliot J. Living systematic reviews: 4. Living guideline recommendations. J Clin Epidemiol. 2017;91:47–53.
Nanton V, Docherty A, Meystre C, Dale J. Finding a pathway: information and uncertainty along the prostate cancer patient journey. Br J Health Psychol. 2009;14(Pt 3):437–58.
doi: 10.1348/135910708X342890 pubmed: 18718111
Holmberg C. Eine ethnographische Studie über Krankheit und Krankheitserleben [Diagnosis Breastcancer: An ethnograpic study on disease and illenss experience]. Frankfurt/new York: Campus Verlag; 2005.
Kaiser M, Adami S, Lucius-Hoene G, Muller-Nordhorn J, Goerling U, Breuning M, et al. Learning-by-doing: the importance of experiential knowledge sharing for meeting the information needs of people with colorectal cancer in Germany-a qualitative study. BMJ Open. 2021;11(2):e038460.
doi: 10.1136/bmjopen-2020-038460 pubmed: 33622937 pmcid: 7907857
Blodt S, Muller-Nordhorn J, Seifert G, Holmberg C. Trust, medical expertise and humaneness: a qualitative study on people with cancer’ satisfaction with medical care. Health Expect. 2021;24(2):317–26.
doi: 10.1111/hex.13171 pubmed: 33528878 pmcid: 8077133
Kleinman A. Care: in search of a health agenda. Lancet. 2015;386(9990):240–1.
doi: 10.1016/S0140-6736(15)61271-5 pubmed: 26194517

Auteurs

S Blödt (S)

AWMF (Association of the Scientific Medical Societies in Germany)-Institute for Medical Knowledge Management (IMWi), c/o Philipps-University, Marburg, Germany.

S Erstling (S)

AWMF (Association of the Scientific Medical Societies in Germany)-Institute for Medical Knowledge Management (IMWi), c/o Philipps-University, Marburg, Germany.

M Becker (M)

Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany.

G Carl (G)

German Prostate Cancer Support Group, Bonn, Germany.

M Follmann (M)

Office of the German Guideline Program in Oncology (GGPO), c/o German Cancer Society, Berlin, Germany.

S Frenz (S)

Women's Self-Help Association Cancer, Bonn, Germany.

C Holmberg (C)

Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany.

T Langer (T)

Office of the German Guideline Program in Oncology (GGPO), c/o German Cancer Society, Berlin, Germany.

A Pachanov (A)

Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Institute for Health Services and Health System Research, Rüdersdorf, Germany.
Centre for Health Services Research, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany.

D Pieper (D)

Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany.
Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Institute for Health Services and Health System Research, Rüdersdorf, Germany.
Centre for Health Services Research, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany.

M Nothacker (M)

AWMF (Association of the Scientific Medical Societies in Germany)-Institute for Medical Knowledge Management (IMWi), c/o Philipps-University, Marburg, Germany. nothacker@awmf.org.

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