Adapt Knowledge to Local Context
Although guidelines provide evidence in a more usable form for practitioners and health settings than a plethora of primary studies, an important and additional necessary step is the adaptation of the guideline to the context of use.
Customizing a clinical practice guideline for a particular organization may help improve acceptance and adherence, and overcome challenges such as health care providers not having the requisite skills and expertise to implement a recommended action, the setting not having the mandatory equipment or staff time to deliver a guideline's recommendation, or recommendations not being acceptable to the local patient population or providers due to culture or other factors.
The ADAPTE collaboration is among the few who provide a validated process for guideline adaptation. The ADAPTE process consists of three main phases, including planning and setup, adaptation, and development of a final product:
- Setup Phase
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Preparation for implementing the ADAPTE framework, which includes:
- establishing and organizing committee and working panel, resource team
- selecting a topic using criteria
- checking if adaptation is feasible
- identifying necessary resources and skills
- completing tasks for the setup phase including terms of reference, declaration of conflicts of interest, consensus process, endorsement bodies, guideline authorship, dissemination, and implementation strategies
- writing the adaptation plan.
- Adaptation Phase
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- Define the health questions.
- Search and screen guidelines.
- Assess guidelines' quality, currency, content, consistency, acceptability and applicability.
- Decide and select.
- Draft adapted guideline and documentation on adaptation process and end-users' need.
- Finalization Phase
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- External review by target audiences and consultation with endorsement bodies and guideline developers.
- Plan for future review and update, such as deciding on a review date and a plan for repeat search and modification.
- Produce final guideline document.