gms | German Medical Science

Background: A patient-centered approach implements a bio-psychosocial model which focuses on all factors that influence health and functioning, inclusive of patient needs and preferences. This perspective should be considered in guideline recommendation development for patient goals, interventions, and outcome measures.

Objective: To develop a position paper to promote a patient-centered approach in guideline development and implementation.

Method: Informed by a literature review, a consensus development process included three narrative discussion formats for data collection: a Nominal Group Technique within a Health Steering group, an internet discussion board, and a workshop at an annual conference. Data was analyzed for relevant themes by two researchers to develop a framework and draft recommendations.

Results: Four recommendations were identified to enhance a patient-centered approach in clinical guidelines: 1) to use a joint definition of Health Related Quality of Life (HRQoL), 2) to use the International Classification of Functioning (ICF) as a construct which covers all domains related to the patient's health, 3) to include a shared decision making model, and 4) to incorporate health outcome measures.

Discussion: The position paper described the essential elements of a patient-centered approach in best practice guideline development. It provided information on the barriers and facilitators which might help to define strategies for patient-centered care.

Implications for guideline developers/users: Four key areas have been identified that need to be addressed in order to embed the bio-psychosocial framework in clinical guidelines, to acknowledge the complex interactions in health, and to ensure that guidelines are patient-centered.