IOM and DHHS Meeting on Making Clinical Practice Guidelines Appropriate for Patients with Multiple Chronic Conditions

The Article in Brief

IOM and HHS Meeting on Making Clinical Practice Guidelines Appropriate for Patients with Multiple Chronic Conditions

Richard A. Goodman , and colleagues

Background One-fourth of all adults, and at least 75% of older adults, have 2 or more chronic conditions. The presence of multiple chronic conditions (MCC) creates many challenges for clinicians, including determining what evidence to use in making clinical decisions and the need to consider patients' contexts and preferences in clinical decision-making. This report summarizes recent policy work by the US Department of Health and Human Services and the Institute of Medicine addressing the challenges of guidelines for people with multiple chronic conditions.

What This Study Found A meeting in May 2012 identified principles and action items for government, guideline developers and others to use in strengthening the applicability of clinical practice guidelines to the growing population of people with MCC. Participants identified 11 principles to improve applicability of guidelines to patients with multiple conditions. The principles were grouped into three categories, intended to: 1) improve the process of developing guidelines; 2) strengthen the content of guidelines in terms of multiple chronic conditions; and 3) increase focus on patient-centered care.

Implications

• The increasing prevalence of people with MCC is accelerating the need for improved clinical practice guidelines for patient management.
• In the absence of a central force for guideline development in the US, collective actions to address MCC in guidelines will require sustained will and commitment both within and outside the government.