PharmacoEconomics & Outcomes News 315 - 2 Jun 2001

Local input needed in nationalguidelines

Local factors need to be taken into account whendeveloping and implementing national guidelines ‘ifthese national initiatives are to lead to improved patientcare and more cost effective use of resources’, accordingto Raymond Jankowski of the Royal Free and UniversityCollege Medical School in London, England.1

Using the findings of a study conducted in Glasgow,Scotland,2 as an example, Jankowski says that it cannotbe assumed that the use of guidelines will result inreduced spending in the UK NHS.* In the Glasgowstudy, no evidence was found that the guidelines led toan improvement in patient outcomes, or to cost savingsfor the NHS. In fact, the authors of the study concludedthat the guidelines may have led to higher overall per-patient costs for the NHS. Jankowski says that hadsecondary-care health professionals been included inthe guidelines’ development, these ‘disappointing’findings may have been avoided. He suggests that, in thefuture, the collaboration of both primary- andsecondary-care health professionals will includephysicians, nurses, occupational therapies,physiotherapists, dieticians, laboratory technicians andothers, reflecting all those ‘who may be affected by orwho may influence the desired change in practice’.* National Health Service

1. Jankowski RF. Implementing national guidelines at local level. BMJ 322:1258-1259, 26 May 2001.

2. Morrison J, et al. Pragmatic randomised controlled trial to evaluate guidelinesfor the management of infertility across the primary care-secondary careinterface. BMJ 322: 1282-1284, 26 May 2001.

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PharmacoEconomics & Outcomes News 2 Jun 2001 No. 3151173-5503/10/0315-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved