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Qualitative evidence synthesis to improve implementation of clinical guidelines

BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j80 (Published 16 January 2017) Cite this as: BMJ 2017;356:j80

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Re: Qualitative evidence synthesis to improve implementation of clinical guidelines

This article raises the very important issues of actual patient experience with reference to NICE and other clinical guidelines. As a psychotherapist I get to hear a lot about patients' experiences - and the huge frustrations of trying to 'feed back' to their doctors these actual experiences. When these experiences don't seem to fit in with 'the guidelines' the patients tend to be disbelieved and apparently 'fobbed off'. There does not seem to be any room for 'learning from experience'. This is especially relevant when clinical trails are usually over relatively short periods - and patients may take medications (and indeed a variety of medications) over long periods.

I have written about this, published on 29 December 2016, in GP View.

This is my article: http://gpview.co.uk/an-outsiders-observation/

If anyone wishes to contact me, my email address is mmarionbrown@gmail.com

Competing interests: No competing interests

18 January 2017
Marion Brown
Psychotherapist (independent)
Helensburgh

Re: Qualitative evidence synthesis to improve implementation of clinical guidelines

Sirs

For type 2 diabetes, dietary advice given by professionals - be that based on quantitative or qualitative evidence - is not always taken. And if one professional gives advice that includes eat fruit and low fat milk products as part of a balanced diet is contradicted by another who says avoid fruit, eat meat and fat, there is every possibility that patients, like me, will cherry pick, excuse the pun, to suit what seems to work for them. Perhaps that's no bad thing.

John

Competing interests: No competing interests

16 January 2017
John G Gooderham
locum lollipop lady
none
none
Billingshurst
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