Page 157 - Shared Guideline Development Experiences in Fertility Care

one of the guidelines). Furthermore, developing CPGs include whole-intensive processes, which costs time and commitment from stakeholders. e di erences in the content and structure of the nal guidelines would also make them non- comparable in the baseline. Finally, performing a budget-impact analysis on the network approach to multidisciplinary guideline development could be considered as well.
Implementation and evaluation of the participatory tool for patients in guideline development within other clinical areas (predominantly within other complex multidisciplinary diseases, such as cancer) should be the next step.
e developed indicators for patient-centredness should be followed by a further practice test to assess its feasibility in daily practice. By evaluating its measurability and the intra- and inter-observer reliability, the core set of 29 indicators for patient-centredness could be reduced by 10–20% [73,77,78]. Finally, its e ects on the quality of patient-centred care needs to be investigated and compared to other instruments that have been developed to improve patient-centred care, such as Patient Reported Outcome Measurements for infertility (i.e. the FertiQol, QPP- IVF instrument, and the PCQ infertility) [41,62,79].
Key implications for future research:
- To evaluate the impact on the implementability of guidelines with a high level of patient involvement is generally impossible since implementation is determined by intrinsic and extrinsic factors.
- It could be debated whether the impact of patient involvement on the quality of care could be captured within a study design such as a (clustered) RCT since ethical barriers, commitment of stakeholders, and costs play a crucial role.
- A budget-impact analysis on the network approach to multidisciplinary
guideline development could be considered. 7
- Implementation and evaluation of the participatory tool for patients in guideline development within other clinical areas (predominantly within other complex multidisciplinary diseases, such as cancer) should be the next step.
- e developed indicators for patient-centredness should be followed by a further practice test to assess its feasibility in daily practice.
- e e ects of the developed set of indicators for patient-centredness on the quality of patient-centred care needs to be investigated and compared to
Discussion
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