School of Psychology, University of Adelaide, Adelaide, Australia.
Curr Opin Oncol. 2021 Jul 1;33(4):273-278. doi: 10.1097/CCO.0000000000000732.
To review the role of evidence-based clinical practice guidelines in promoting the quality and consistency of supportive care in oncology to meet the needs of practitioners and patients.
To maintain quality, guidelines must be regularly updated in terms of content as new treatment modalities like immunotherapy are introduced, adapted to new methodologies such as the application of artificial intelligence, adoption of multiple symptoms or orphan symptoms and capture new endpoints such a patient-reported outcomes. This helps prevent a major barrier to implementation; negative attitudes of practitioners towards guidelines. Digital guidelines provide greater opportunities for dissemination, ease of updating and can be linked to education modules. The quality must be assured by critically appraising the literature and then grading the level of evidence of the guidelines. The benefits of supportive care guidelines include guidance for clinical decision-making in a changing field, continuing professional development of practitioners, a source of information for patients and in highlighting the gaps where further research is necessary.
The implications are that guidelines are required for supportive care in cancer but they must be constantly updated and evolve in their structure, the rigour of appraisal and content to promote quality care.
审查循证临床实践指南在促进肿瘤支持性护理质量和一致性方面的作用,以满足从业者和患者的需求。
为了保持质量,必须根据新的治疗方法(如免疫疗法)定期更新指南的内容,适应新的方法,如人工智能的应用、多种症状或孤儿症状的采用以及捕获新的终点,如患者报告的结果。这有助于防止实施的主要障碍;从业者对指南的负面态度。数字指南为传播、更新的便利性提供了更大的机会,并且可以与教育模块相关联。通过严格审查文献并对指南的证据水平进行分级,可以保证质量。支持性护理指南的好处包括为不断变化的领域的临床决策提供指导,为从业者的继续专业发展提供指导,为患者提供信息,并突出需要进一步研究的空白。
这意味着癌症支持性护理需要指南,但它们必须不断更新,在结构、评估严谨性和内容方面不断发展,以促进高质量的护理。