Disseminating Clinical Practice Guidelines for Obesity

I'm Dr. Kathy Breen, a clinical specialist dietitian, and I'm chair for the Association for the Study of Obesity in Ireland.

In the next five minutes, I'm going to give you some perspectives on adapting and implementing clinical practice guidelines for obesity in Ireland.

Okay, so let's get started.

So, we know the clinical practice guidelines help us to standardize and improve the quality of healthcare delivery by guiding clinicians and healthcare systems on evidence-based care.

We know they can reduce healthcare inequalities, promote delivery of more consistent cost-effective care, and reduce bias.

However, on the other hand, high-quality guidelines can take a long time and be costly to produce.

And even worse, sometimes after all that effort, they can sit on shelves gathering dust.

So the real benefit of clinical practice guidelines is when they're implemented at a systems level and used to guide daily clinical practice for health care professionals.

So in 2022, we adapted the Canadian adult obesity clinical practice guidelines for use in Ireland.

And I'm going to share some of our learnings for how we did this and how we maximized the likelihood of implementation through that project.

So firstly, we engaged with a really wide group of stakeholders.

We included policymakers, health system leaders, academics, people with lived experience of obesity and lots of frontline clinicians from both primary and secondary care and a really broad range of specialities.

This was really essential for buy-in and use of the guidelines in both the education and practice of clinicians in our country.

Secondly, our timing was really good.

The Health Service had just launched a model of care for obesity, which referenced the Canadian guidelines and acknowledged the need for local guidance that took account of the nuances of the Irish health care system.

So we capitalized on that and our adaptation took the best of the high quality evidence in the original guidelines and tweaked it for use in our own healthcare system.

So we found that having a good hook really helped us to get buy-in again to the guidelines from policymakers.

Thirdly, we were careful to either align with or integrate, but not in any way conflict with existing clinical guidance in Ireland.

So for example, we linked in with the British Obesity and Metabolic Surgery Society in the United Kingdom and incorporated their post-bariatric surgery guidance into our adapted guideline, because that's something the Irish clinicians would have very commonly referred to.

Fourthly, we adapted 18 chapters of the Canadian guidelines.

So that means that our adapted guideline are very broad and holistic and approach obesity from all perspectives, from prevention to treatment.

They include all the clinical approaches for medical nutrition therapy, activity, psychology, pharmacotherapy, surgery, health behaviours, the spectrum, including topics of more niche interest such as reproductive and mental health.

Again, that's enhanced the credibility of the guidelines by not introducing any bias in promoting any one treatment option over another when we're developing national policies.

Fifthly, we maintained the Obesity Canada template for having clear, concise, key messages for policy makers, healthcare professionals and people living with obesity at the beginning of each chapter.

This has made the content of the chapters really accessible for everyone, so whether they want the granular detail, the judge bind in the PDF, or just a top line summary, they're both in there.

Moving on from this, the Irish Coalition for People Living with Obesity have used those key messages to develop information leaflets for people living with obesity.

And that's helped to further disseminate what good evidence-based practice really looks like in obesity care.

Speaking of accessibility, we also made sure that the guidelines themselves are very accessible and easy to download from our website.

And that's again, helped with dissemination because we can easily signpost to one place where the information is consistent.

So in summary, if you're considering adapting clinical practice guidelines, our advice would be to engage a wide range of stakeholders that are important in your country, to find a hook that makes the adaptation important to policy makers, to maximize buy-in, to align as well as you can with other national guidance or good practice in your own healthcare system, to take a holistic approach for the credibility and quality of the guidelines, and finally, to make the finished product easily accessible to maximize dissemination.

I'm Dr. Kathy Breen for 5 Minute CPD.

Thank you for watching and be sure to check out the additional resources on this page and more learning at easo.org.