Page 39 - Shared Guideline Development Experiences in Fertility Care

infertile couples to participate in our study can introduce a potential selection
bias: we do not know if these couples are representative of the general infertile
population. However, regarding the time restraints in the guideline development
process and our aim of using input of patients in the rst phase, we used a practical
approach. e authors believe that this is a rst initiative to involve patients in this
rst step of the guideline development process. Furthermore, the authors believe 2 that a systematic literature search on patients’ preferences for care and outcome measurements should complete patients’ input in this rst phase of guideline development.
e patients’ and professionals’ key clinical issues that resulted from this study could inform the next step of the guideline development process, namely in developing the key questions as well as form a valuable addition in de ning the associated outcome measurements. Regarding the mentioned key clinical issues, this could result in key questions like: ‘how to treat patients best’ (attitude and partner involvement), ‘how to organize information provision to infertile couples and what kind of information do patients value’ and ‘which place does emotional support have in fertility care and when and by whom should this be provided’.
Although the direct impact of these study results is more or less speci c for fertility care, we believe that this approach could form an example for guideline developers and policy makers (inter)nationally in making multidisciplinary guidelines as well as other quality derived products (e.g. protocols in which the organization forms an important aspect) more tailored to patients. However, guideline developers may approximately need an extra month to recruit patients, conduct interviews, analyse the results and receive patients’ remarks in order to precede the underpinning key questions. In the light of delivering high quality patient-centred care, the engagement of patients in an early phase of the development of products that guide the clinician, could form one of the strategies to bring this to a higher level. Finally, although suggestive, tailoring clinical guidelines to patients’ perspective in this way may suggest that the guideline will be well implemented it may also interfere in a positive way with patient satisfaction, costs and improved outcomes [46]. Hence, patients’ input to the scoping phase of guideline development may be worth the relatively small amount of extra time. For such, further studies on the e ects on guideline implementation, the level of patient-centred care and patient satisfaction could build to the strength of the recommendation to move towards shared guideline development, from the rst till the last step.
Key clinical issues in fertility care
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