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Can Australia’s clinical practice guidelines be trusted?

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To the Editor: In response to the news article from the National Health and Medical Research Council (NHMRC) published recently in the Journal,1 we would like to highlight a generally neglected facet of the clinical guidelines discussion: acceptability. While it is clearly critical for clinical guidelines development to adopt a thorough and transparent process, it is equally important to focus on the end user.2 Many good quality clinical guidelines lay unused because they ignore practitioner requirements, including practical, design and context-specific needs.3

Remote Primary Health Care Manuals (RPHCM) are clinical guidelines that have been published in Central Australia since 1993. They were originally developed to enable standardised and evidence-based practice in the context of remote Aboriginal health care. Repeat evaluations have confirmed the high acceptability of and compliance with the guidelines.4 The “by the users, for the users” approach to their development contributes significantly to their high acceptability and uptake.

We monitor NHMRC recommendations closely to direct and improve our guideline development, and adopt a vigorous and continuous quality improvement process, including recording details and conflicts of interests…