Hostname: page-component-8448b6f56d-xtgtn Total loading time: 0 Render date: 2024-04-20T03:06:21.241Z Has data issue: false hasContentIssue false

Translating Evidence into Practice: The Case of Dementia Guidelines in Specialized Geriatric Services

Published online by Cambridge University Press:  31 March 2010

David L. Lewis*
Affiliation:
Regional Geriatrics Program central, Hamilton Division of Geriatrics, Department of Medicine, Faculty of Health Sciences, McMaster University
David Jewell
Affiliation:
Regional Geriatrics Program central, Hamilton Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University
Irene Turpie
Affiliation:
Division of Geriatrics, Department of Medicine, Faculty of Health Sciences, McMaster University St. Joseph's Healthcare Hamilton
Christopher Patterson
Affiliation:
Division of Geriatrics, Department of Medicine, Faculty of Health Sciences, McMaster University Hamilton Health Sciences
Barbara McCoy
Affiliation:
Alzheimer Society of Hamilton & Halton
Julia Baxter
Affiliation:
St. Joseph's Healthcare Hamilton Halton Geriatric Mental Health Outreach Program
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être adressées à : David Lewis, Ph.D., Regional Geriatrics Program Central, 88 Maplewood Avenue, Hamilton, ON L8M 1W9. (lewisda@mcmaster.ca)

Abstract

This paper describes a process of identifying best practice guidelines for non-pharmacological management for individuals with dementia and disseminating them to a group of frontline practitioners in specialized geriatric services. Our dissemination plan involved early participation of practitioners, development of a chart summarizing five guidelines showing commonalities, contrasts, and gaps in the guidelines, and their interpretation, colour-coded for the strength of the evidence on which they were based. Two sequential workshops were held in which recommendations for action were developed. Outcomes of the process included a resource manual, a network of practitioners, and action recommendations based upon survey data. An early follow-up evaluation showed increased adoption of guidelines.

Résumé

Cette étude décrit un processus qui consiste à déterminer des pratiques exemplaires pour le traitement non pharmacologique des individus atteints de démence et à les diffuser auprès d'un groupe de praticiens de première ligne en services gériatriques spécialisés. Notre plan de diffusion comportait une participation des praticiens dès les premières étapes, l'élaboration d'un diagramme résumant les cinq lignes directrices et expliquant les points communs, les contrastes et les lacunes de ces lignes directrices, ainsi que leur interprétation, au moyen de codes de couleur selon la pondération des preuves sur lesquelles elles étaient fondées. Deux ateliers séquentiels, au cours desquels des mesures ont été recommandées, ont été organisés. Un manuel de ressources, un réseau de praticiens ainsi que des recommandations fondées sur les données de l'étude ont été tirés de ce processus. Une évaluation de suivi effectuée peu après a révélé une connaissance accrue des lignes directrices.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Auriat, N. (1998). Social policy and social enquiry: Reopening debate. International Social Science Journal, 156, 275287.CrossRefGoogle Scholar
Booth, A., Djulbegovic, B., Guthrie, B., Perleth, M., Sackett, D., Endersly, S., Jenkins, D., Richardson, S., Taylor, C., Dent, T., & Enkin, M. (n.d.). What proportion of healthcare is evidence based? Retrieved 20 January 2004 from http://www.shef.ac.uk/scharr/ir/percent.htmlGoogle Scholar
Bradley, E.H., Webster, T.R., Baker, D., Schlesinger, M., Inouye, S.K., Barth, M.C., Lapane, K.L., Lipson, D., Stone, R., & Koren, M.J. (n.d.). Translating research into practice: Speeding the adoption of innovative health care programs. Commonwealth Fund issue brief (#724). Retrieved 18 July 2004 from http://www.cmwf.org/publications/publications_show.htm?doc_id=233248Google Scholar
Canadian Consensus Conference on Dementia (1999). Management of dementing disorders: Conclusions from the Canadian Consensus Conference on Dementia. Canadian Medical Association Journal, 160 (Suppl. 12), S5.Google Scholar
Canadian Health Services Research Foundation (1999, May) Issues in linkage and exchange between researchers and decision makers: Summary of a workshop convened by the Canadian Health Services Research Foundation. Montreal. Retrieved 1 April 2004 from http://www.chsrf.ca/knowledge.transfer/pdf/linkage_e.pdfGoogle Scholar
Canadian Medical Association. (n.d.). CMA InfoBase: Clinical practice guidelines. Retrieved 29 May 2003 from http://mdm.ca/cpgsnew/cpgs/search/english/results.asp?id=2Google Scholar
Central West Health Planning Information Network (2000). A framework for evaluating the utilization of health information products. Retrieved 15 January 2004 from www.cwhpin.ca/cwhpin/reports/report_2000_02.pdfGoogle Scholar
Cohen-Mansfield, J., & Werner, P. (1998). Longitudinal changes in behavioural problems in old age: A study in an adult day care population. Journal of Gerontology A: Biological Science Medical Science, 53, M65M71.Google Scholar
Cummings, J.L., Frank, J.C., Cherry, D., Kohatsu, N.D., Kemp, B., Hewett, L., & Mittman, B. (2002). Guidelines for managing Alzheimer's disease, part II: Treatment. American Family Physician, 65(11), 25252534.Google ScholarPubMed
Davis, D.A., & Taylor-Vaisey, A. (1997). Translating guidelines into practice: A systematic review of theoretic concepts, practical experience and research evidence in the adoption of clinical practice guidelines. Canadian Medical Association Journal, 157, 408416.Google Scholar
Davis, P., & Howden-Chapman, P. (1996). Translating research findings into health policy. Social Science and Medicine, 43(5), 865872.CrossRefGoogle ScholarPubMed
Doody, R.S., Stevens, J.C., Beck, C., Dubinsky, R.M., Kaye, J.A., Gwyther, L., Mohs, R.C., Thal, L.J., Whitehouse, P.J., DeKosky, S.T., & Cummings, J.L. (2001). Practice parameter: Management of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology, 56, 11541166.Google ScholarPubMed
Field, M.J., & Lohr, K.N. (Eds.). (1992). Guidelines for clinical practice: From development to use. Washington, DC: National Academy Press.Google Scholar
Jewell, D., Turpie, I., Patterson, C., Lewis, D., & Baxter, J. (2003). A one minute survey of learning needs for Regional Geriatric Program central personnel. Geriatrics and Aging, 6(1), 5961.Google Scholar
Lomas, J., & Anderson, G.A. (1989). Do practice guidelines guide practice? The effect of a consensus statement on the practice of physicians. New England Journal of Medicine, 321, 13061311.CrossRefGoogle ScholarPubMed
Michaud, G., McGowan, J.L., van der Jagt, R., Wells, G., & Tugwell, P. (1998). Are therapeutic decisions supported by evidence from health care research? Archives of Internal Medicine, 158(15), 16651668.CrossRefGoogle ScholarPubMed
NHS Centre for Reviews and Dissemination, University of York (1999). Getting evidence into practice. Effective Health Care, 5(1), 116.Google Scholar
Orell, M. (1996). Tacrine and psychological therapies in dementia: No contest? International Journal of Geriatric Psychiatry, 11, 189192.3.0.CO;2-K>CrossRefGoogle Scholar
Regional Geriatric Program central (2002). Forging ahead: Progress report of RGP central. Retrieved 5 February 2004 from http://www.rgpc.ca/files/ForgingAhead.pdfGoogle Scholar
Scottish Intercollegiate Guidelines Network (1998). Interventions in the management of behavioural and psychological aspects of dementia. Publication 22 (QRG). Retrieved 23 January 2003 from http://www.sign.ac.uk/pdf/qrg22.pdfGoogle Scholar
Trochim, W.M.K. (2000). Likert Scaling. Retrieved 19 July 2005 from http://www.socialresearchmethods.net/kb/scallik.htmGoogle Scholar
United States. Department of Health and Human Services. (n.d.). National Guideline Clearinghouse. Retrieved 29 May 2003 from www.guidelines.govGoogle Scholar
West, S., King, V., Carey, T.S., Lohr, K.N., McKoy, N., Sutton, S.F., & Lux, L. (2003). Systems to rate the strength of scientific evidence: Evidence report/technology assessment number 47. Washington, DC: Agency for Healthcare Research and Quality.Google Scholar
Working Group on Alzheimer's Disease and Related Dementias (1997). Practice guideline for the treatment of patients with Alzheimer's disease and other dementias of late life. American Journal of Psychiatry, 154(5), 138.CrossRefGoogle Scholar