Page 62 - Shared Guideline Development Experiences in Fertility Care

Chapter 3
the patient) and their contributions as ‘bene cial to the nal product’ (e.g., a ecting formulations of considerations or expert-based recommendations). e representatives emphasized the need for information about the components of clinical care pathways before they discussed treatment options. More than one- half of the respondents described the nal patient recommendations as ‘valuable’ or ‘eye-openers’, and ‘useful’ in formulating professional recommendations. Some of them doubted the practical applicability of these recommendations. ey questioned the fact that patients recommended that the physician immediately refer patients trying to conceive to the gynaecologist. ey noted the lack of new insights in patient recommendations.
Facilitators and barriers
Facilitators for the network approach included the selection of the most competent and dedicated participants, the introduction of the project coordinator, and patient contributions. Perceived political barriers, competing professional interests of those involved, and the lack of a more detailed MuG format created barriers. Suggestions for improvement included communication of clear instructions for individual roles and responsibilities, a strict schedule including deadlines, and a clear format for the guidelines. Further, the need for supportive sta and support for literature searches were noted.
Discussion
is study provides detailed insight into the feasibility of a novel patient-centred network approach to MuG development for fertility care. is approach enabled the collaborative development of a harmonized set of one MuG and four MoGs for clinical care pathways for infertile couples. e approach helped us foresee possible barriers analogous to the US Institute of Medicine recommendations for developing trustworthy and transparent CPGs [9].
All the relevant stakeholders were included in the guideline groups. Collaboration between balanced groups of key stakeholders is an important success factor for clinical networks and may lead to a more valid method of developing guidelines [9,10]. A crossover of stakeholders from one guideline group to another helped harmonize the guideline content and distribute questions among the groups. is emphasized speci c professional contributions and created a feeling of a nity
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