A collaborative model for the development of CVD clinical guidelines in Australia

  • Jinty Wilson, National Manager - Clinical Programs, National Heart Foundation of Australia, VIC, Australia
  • Dr Andrew Boyden, National Director - Clinical Issues, National Heart Foundation of Australia, VIC, Australia
  • Dr Gill Westhorp, Director, Community Matters, SA, Australia
  • Dr Kerryn Coleman, Department of Health and Ageing, Office for Aboriginal and Torres Strait Islander Health (OATSIH), ACT, Australia
  • Dr Heather Buchan, National Health and Medical Research Council /National Institute for Clinical Studies (NHMRC-NICS), VIC, Australia
  • Prof Mark Harris, Royal College of General Practitioners & University of New South Wales, NSW, Australia
  • Dr David Mountain, Australian Healthcare & Hospitals Association & Sir Charles Gairdner Hospital, WA, Australia
  • A/Prof John Atherton, 8Cardiac Society of Australia and New Zealand & Royal Brisbane & Womens Hospital, QLD, Australia

The Heart Foundation was commissioned by the Department of Health and Ageing (DoHA) to outline a collaborative model for cardiovascular disease (CVD) guideline development that is compatible with National Health and Medical Research Council (NHMRC) standards. A formal proposal to trial and evaluate the innovative model was also developed.
Areas investigated included:
• prioritisation processes
• considering implementation issues during guideline development
• indicators of clinical effectiveness
• maintaining currency
• addressing socioeconomic factors, and challenges facing Aboriginal and Torres Strait Islander peoples
Methods: The project Advisory committees had oversight of:
1. a baseline assessment of current Australian practice in guideline development and a review of inter/national literature;
2. Two consultation rounds using an adapted on-line Delphi Technique (informed by 1.) involving a broad range of stakeholders to explore options for, and identify areas of consensus in guideline development processes.
Results: There was strong stakeholder support for establishing a nationally-coordinated and funded guideline development framework. Potential components of an improved model for CVD clinical guidelines development identified include:
- transparent processes for the selection of topics.
- mechanisms to highlight research needs where evidence gaps are identified.
- implementation planning occurs during guideline development.
- clinical indicators are developed in parallel to guideline development processes
- guidelines are approved, accredited or endorsed by relevant professional bodies, in addition to NHMRC.
Conclusion: Nationally prioritised CVD guidelines which address implementation issues during the development phase have the potential to underpin the development of nationally-agreed standards for the prevention and management of CVD.