Challenges and Stimulating Factors for the Incorporation of Economic Considerations in Clinical Practice Guidelines: A Scoping Review

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES Journal of evaluation in clinical practice Pub Date : 2024-12-11 DOI:10.1111/jep.14264

Chloé A. de Mortier, Jen Yaros, Ghislaine A. P. G. van Mastrigt, Daniëlle M. L. Verstegen, Silvia M. A. A. Evers, Marian H. J. M. Majoie, Dunja H. H. Dreesens, Aggie T. G. Paulus

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Abstract

Rationale, Aims and Objectives

The incorporation of economic considerations in clinical practice guidelines (CPGs) could help promote cost-conscious decision-making in healthcare. Though healthcare expenditures increase, and resources are becoming scarcer, the extent to which economic considerations are incorporated into CPGs remains limited. This scoping review aims to identify the challenges and potential stimulating factors to incorporate economic considerations in CPGs.

Method

This scoping review was conducted following the Joanna Briggs Institute Methodology and findings were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A systematic search was conducted in eight databases considering literature published from July 2017 and onwards. Data extraction was conducted via an iterative and inductive approach to identify challenges and potential stimulating factors from the included reports. Included documents focused on the (para)medical field and reported on CPG development and economic considerations.

Results

The search identified 2445 documents from which 33 documents were included for analysis. The analysis identified five challenges: discourse surrounding economic considerations in CPGs, methodological ambiguities, scarcity of (high-quality) economic evidence, transferability of evidence, and resource constraints. Additionally, three potential stimulating factors were identified: acceptance, economic evidence knowledge, and guidance on incorporating economic considerations.

Conclusion

These findings reflect the complexity of incorporating economic considerations in CPGs. The identified challenges highlight the need for clearer guidance (i.e. by training) and standardised methodologies for incorporating economic considerations in CPGs. The potential stimulating factors provide a roadmap for future efforts to enhance the integration of economic evidence in CPGs. Collaborative initiatives between health economists, CPG developers, and other stakeholders are essential to drive progress in this area and promote cost-conscious decision-making in healthcare.

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在临床实践指南中纳入经济考虑的挑战和刺激因素：范围审查。

基本原理、目的和目标：在临床实践指南（cpg）中纳入经济考虑可以帮助促进医疗保健中的成本意识决策。尽管医疗保健支出增加，资源变得越来越稀缺，但将经济因素纳入CPGs的程度仍然有限。这项范围审查旨在确定挑战和潜在的刺激因素，以纳入CPGs的经济考虑。方法：本综述遵循乔安娜·布里格斯研究所方法论进行，研究结果根据系统综述和荟萃分析扩展综述（PRISMA-ScR）指南的首选报告项目进行报告。系统检索了8个数据库，考虑了2017年7月及以后发表的文献。通过迭代和归纳方法进行数据提取，以确定所包含报告中的挑战和潜在刺激因素。包括以（第）段医疗领域为重点的文件，并报告了CPG的发展和经济考虑。结果：共检索到2445份文献，其中纳入33份文献进行分析。该分析确定了五个挑战：围绕CPGs中经济考虑因素的论述、方法的模糊性、（高质量）经济证据的稀缺性、证据的可转移性和资源限制。此外，还确定了三个潜在的刺激因素：接受度、经济证据知识和纳入经济考虑的指导。结论：这些发现反映了在CPGs中纳入经济考虑的复杂性。所确定的挑战突出表明，需要更明确的指导（即通过培训）和将经济考虑纳入CPGs的标准化方法。潜在的刺激因素为未来加强CPGs中经济证据的整合提供了路线图。卫生经济学家、CPG开发者和其他利益相关者之间的合作倡议对于推动这一领域的进展和促进医疗保健领域的成本意识决策至关重要。

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来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.