Integrating Patients Into Programmes to Address the Allergy Knowledge Practice Gap
ABSTRACT There is a wide gap between the first publication of new treatments with efficacy and their successful application in clinical practice. In many respects, the management of allergic diseases is a good exemplar of the knowledge/practice gap. It was assumed that systematic reviews and publica...
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| Published in: | Clinical and experimental allergy Vol. 54; no. 10; pp. 723 - 733 |
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| Main Authors: | , |
| Format: | Journal Article |
| Language: | English |
| Published: |
England
Wiley Subscription Services, Inc
01-10-2024
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | ABSTRACT
There is a wide gap between the first publication of new treatments with efficacy and their successful application in clinical practice. In many respects, the management of allergic diseases is a good exemplar of the knowledge/practice gap. It was assumed that systematic reviews and publication of guidelines would ensure timely delivery of effective care, but this has not proved to be the case. While there are many reasons to explain shortcomings in healthcare delivery, the lack of patient and carer involvement in the planning of research, evidence review, guideline development and guideline implementation is most compelling. To achieve adherence to evidence‐based guidelines consistently across all levels of the health service requires the implementation of integrated care with clear pathways through which patients can navigate. Quality improvement methodology could be employed to plan and implement integrated care pathways (ICPs). There is evidence that ICPs achieve improved outcomes for acute hospital‐based interventions, but less work has focussed on long‐term conditions where more diverse agencies are involved. At all stages, stakeholder representation from the full range of healthcare professionals, patients, their families, social services, education, local government and employers must be involved. In this article we review the step‐wise and iterative process by which knowledge is implemented into practice to improve patient experience and outcomes We argue how this process can benefit from the involvement of patients and their carers as equal partners, and we discuss how different initiatives have involved patients with allergic diseases. There currently is a gap in evidence that links patient involvement to improved outcomes. We recommend the use of the Core Outcome Sets (COS) and Patient Reported Experience Measures (PREMS) which have been developed for allergic diseases to monitor the effects of implementation research and the impact of patient and carer involvement on outcomes.
Publication of effective new treatments and incorporation into guidelines does not always lead to timely patient benefit. Effective implementation of guidelines through integrated care pathways requires quality improvement methodology. Patients need to be involved at all stages—from research and development to guideline development through to quality improvement initiatives—to close the knowledge/practice gap. |
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| Bibliography: | The authors received no specific funding for this work. Funding ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23 |
| ISSN: | 0954-7894 1365-2222 1365-2222 |
| DOI: | 10.1111/cea.14563 |