Clinical Practice Guidelines for HP-DP and Management
The concepts of evidence-based medicine (EBM) and evidence-based practice (EBP) reflect a systematic review of the validity methods for patient-client assessment, diagnoses, and treatment. When a team conducts a meta-evaluation and meta-analysis to define a science base for an intervention, it should always review and reference Clinical Practice Treatment, or HP-DP Program Guidelines. The Cochrane Collaborative Review should also be a primary source to identify the “state of the science-practice” for the diagnosis, treatment, and management of all diseases and health and safety conditions. These reviews define the quality of the evidence base, or Evaluation PHASE of HP-DP program development and define its readiness to disseminate.
In the United States, Congress established the Agency for Health Care Policy and Research (AHCPR) in 1989, and its successor, the Agency for Healthcare Research and Quality (AHRQ) in 2000. AHRQ has two primary responsibilities: to review clinically relevant guidelines to assist physicians, educators, and healthcare practitioners in determining how diseases can be most effectively prevented, diagnosed, and managed clinically, and to establish standards of quality, performance measures, and medical review criteria. As mandated by the US Congress, each of the 27 US National Institutes of Health (NIH) also produce “State of the Science Reports” and “Treatment Guidelines” for specific diseases for which they are the lead agency. All national governments in high-income countries have a health agency or ministry with the same mission as AHRQ, for example, the National Institute of Health and Clinical Excellence (NICE) in the United Kingdom.
A large number of clinical practice guidelines and national and international consensus reports on specific diseases and/or conditions have been published and disseminated in the last two decades, for example for HIV/ AIDS treatment; tuberculosis (TB) control; smoking cessation; oral rehydration; malaria control; and high blood pressure, asthma, cholesterol, and Type 1 and 2 diabetes control and management. These disease prevention and management guidelines define the process and outcomes of quality healthcare: all integral components of an HP-DP evaluation plan. Evaluators need to thoroughly review these sources and their methods to improve planning and evaluation practice for programs, professionals, patients, and families in healthcare settings. Reports from these national agencies provide guidance about the internal and external validity of treatments.
All evaluations will face challenges produced by the heterogeneity of clients and staff and programs for all health and safety problems. Evaluation specialists and teams need to be knowledgeable about the trends, politics, policies, and organization of disease prevention, diagnosis, treatment, and management programs in their local area, region, and country. Evaluation leadership and staff must also have up-to-date information about the infrastructure, capacity, and financing of health services, especially for all evaluation sites and area(s) for the HP-DP program.