Clinical practice guidelines are systematically developed consensus statements to assist health professionals in their decision-making about appropriate treatments for specific problems. Sometimes surveys are used with as many as 65-100 of the leading experts in each field polled, as in the Expert Consensus Guideline Series. Conferences, a web page, continuing education as well as working with policy makers in the public sector and in managed care are often part of the process of constructing "best practice" guidelines.
In medicine, compliance with published clinical valid and scientifically based guidelines seems to improve patient outcomes. Their efficacy in mental health has not been established, but they are useful guides to interventions that have demonstrated some success. As the authors of the Expert Consensus Guideline Series noted:
The honest answer for many of the questions is that we simply don't know. Throughout history, conventional wisdom has often been wrong. Expert opinion must always be subject to the corrections provided by the advance of science. Moreover, precisely because we asked the experts about the most difficult questions facing you in clinical practice, many of their recommendations must inevitably be based on incomplete research information and may have to be revised as we learn more. Despite this, the aggregation of the universe of expert opinion is often the best tool we have to develop guideline recommendations. Certainly the quantification of the opinions of a large number of experts is likely to be much more trustworthy than the opinions of a small group of experts or of any single person.
The dissemination of practice guidelines is part of the push throughout the health field to standardize treatment. One rationale that professionals have for engaging in the creation of practice guidelines is to forestall the imposition of guidelines by constituencies that have less clinical scientific goals (cost containment, bureaucratic simplicity, spreading potentially idiosyncratic personal opinion). However, it needs to be highlighted that guidelines are never a substitute for good clinical judgment and common sense. In addition, there is a clear emphasis on cognitive-behavioral approaches in most of the guidelines.
Sites With Online Practice Guidelines
 National Institute of Health (NIH)
NIH has convened working groups of clinical researchers and experts to develop practice guidelines about:
 Diagnosis and Treatment of Attention Deficit Hyperactivity Disorder
Effective Medical Treatment of Opiate Addiction
Interventions to Prevent HIV Risk Behaviors
Diagnosis and Treatment of Depression in Late Life
Treatment of Panic Disorder
Differential Diagnosis of Dementing Diseases
Electroconvulsive Therapy
Mood Disorders: Pharmacologic Prevention of Recurrences
The Expert Consensus Guideline Series
Expert Knowledge Systems, the publisher of these guidelines, describes itself as a knowledge-transfer company dedicated to bringing expert intelligence to bear on critical decision making for government, industry, and the individual. It has a steering committee of three psychiatrists. They have published guidelines for:
Treatment of Behavioral Emergencies
Treatment of Depression in Women Bipolar Disorder
Schizophrenia
Obsessive-Compulsive Disorder
Agitation in Older Persons with Dementia
National Guideline Clearinghouse (NGC)
NGC is a public resource for evidence-based clinical practice guidelines sponsored by the Agency for Health Care Policy and Research in partnership with the American Medical Association and the American Association of Health Plans. In the mental health area, it has guidelines for 98 mental disorders including::
Anxiety Disorders
Delirium, Dementia, Amnestic, Cognitive Disorders
Eating Disorders
Mental Disorders Diagnosed in Childhood
Mood Disorders
Schizophrenia and Disorders with Psychotic Feature
Sexual and Gender Disorders
Substance-Related Disorders
American Psychiatric Association (APA)
The APA has developed guidelines for:
Panic Disorder
Psychiatric Evaluation of Adults
Bipolar Disorder
Major Depressive Disorde in Adults
Eating Disorders
Substance Use Disorders: Alcohol, Cocaine, Opioids
Alzheimer's Disease and Other
Dementias of Late Life
Schizophrenia
Nicotine Dependence
AusEinet Good Practice Guidelines
The Australian Early Intervention Network for Mental Health in Young People has developed good practice guidelines for a number of conditions impacting on the mental health of young people including:
Depression
ADHD
 REQUIRED QUEST EXERCISE: 12
Practice Guidelines
Go to The Expert Consensus Guideline Series. The guide for attention deficit disorder also covers what other problem?
a) autism b) learning disabilities c) hyperactivity d) none of the above
Record your answer for later insertion into the Quiz. |
|
