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July 16, 2021, 4:33 p.m. Michael Devitt — AAFP members have consistently ranked clinical guidance as one of the most valuable components of their membership. In response, the Academy is embarking on a project designed to make it easier for family physicians to review and share the clinical guidelines and related information that help them provide optimal patient care.
The first step in that project is the development of a new COPD webpage. The COPD: Clinical Guidance and Practice Resources page is part of a long-term goal to renovate the Clinical Recommendations section of AAFP.org. The page provides members with access to the latest educational materials, toolkits, peer-reviewed journal articles, CME products and more, all in one convenient location.
The central focus of the COPD clinical guidance webpage is to provide recommendations for screening and treatment, as well as additional resources for education and practice management. Melanie Bird, Ph.D., M.S.A.M., clinical and health policy manager in the Academy’s Division of Health of the Public and Science and lead staff for the development of AAFP clinical guidelines, provided the impetus behind the updated web strategy.
“One of our key strategic objectives is to equip members with clinical expertise to provide high-quality, evidence-based care,” Bird told AAFP News. “To this end, the AAFP provides several different types of guidance for the prevention and management of acute and chronic conditions.
“The benefit to this array of guidance is that our members have access to recommendations that can assist them in the care of patients across the lifespan of their patient panel,” continued Bird. “A drawback is that this guidance may not always be linked to, or with, other resources across the Academy.
“The new clinical guidance pages are intended to resolve that issue. By focusing on several priority topics, we are working to optimize our clinical recommendation webpages to provide curated clinical guidance along with implementation tools and education resources."
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Bird added that this comprehensive approach has been in development for some time, with initial work started on the previous iteration of AAFP.org. She also credited the Commission on Health of the Public and Science for its dual roles in developing the Academy’s clinical guidelines and the new guidance pages.
The webpage’s signature feature is a new clinical practice guideline from the AAFP titled “Pharmacologic Management of COPD Exacerbations.” The guideline received approval from the AAFP Board of Directors in April, was published online in June and appeared in print in the July issue of American Family Physician.
James Stevermer, M.D., M.S.P.H., vice chair for clinical affairs and a professor in the Department of Family and Community Medicine at the University of Missouri School of Medicine in Columbia, and chair of the guideline development group, told AAFP News that the guideline is useful in that it not only outlines appropriate care for patients with an acute exacerbation of COPD, but also identifies information gaps that could be addressed through future research.
“I applaud the Academy’s support in developing evidence-based guidelines for problems common in primary care,” said Stevermer. “These can then be put into practice by family physicians to provide the high-quality, evidence-based care that our patients expect from us.”
Stevermer explained that the AAFP adheres to a strict methodology when developing clinical practice guidelines with a transparent framework to provide recommendations consistent with the quality of the evidence, and patient preferences and values, and that address patient-oriented outcomes.
The new COPD guideline, Stevermer continued, was developed by a panel representing relevant stakeholders, including perspectives from family medicine, pulmonology and patients, and guideline methodology, and was based on a systematic evidence review from the Agency for Healthcare Research and Quality.
The new guideline recommends the use of glucocorticoids and antibiotics for patients with acute exacerbations of COPD, which Stevermer observed is already common in clinical practice. The guideline also notes that the use of albuterol is very common to help with symptom relief.
Stevermer added that the guideline panel had initially asked several key questions to address both pharmacologic and nonpharmacologic treatments for COPD, and were hoping to provide further guidance for many of the key decisions family doctors make in caring for their patients with acute exacerbations.
“Unfortunately, the evidence review found very little helpful data on many of these key points,” Stevermer said, adding, “I believe our guideline helps to identify these information gaps, and I look forward to that research coming forth.”
Aside from the new guideline, other AAFP-specific content featured on the webpage includes links to implementation resources, billing and coding information, CME courses on pulmonary medicine and respiratory conditions, patient education materials on COPD and other respiratory conditions from familydoctor.org, and the AFP by Topic collection on COPD.
According to Bird, each of the new clinical guidance webpages, when finalized, will integrate clinical, implementation and education guidance to ensure standardized care for specific conditions commonly seen in family medicine practices. Members are welcome to provide feedback on the new pages or suggest topics for guidance by emailing clinicalpolicies@aafp.org.
Make sure to bookmark the Clinical Recommendations index page to find the latest updates.