Role of guidelines in clinical practice for the management of HIV-related diseases.
Several guidelines have been developed for the diagnosis, treatment and prevention of infectious diseases. Actually, evidence-based clinical practice guidelines provide physicians and other health care professionals with scientific information about the most appropriate strategy for the management of these patients, in order to avoid unnecessary or inappropriate interventions. As medical technology rapidly increases and becomes more complex, clinical guidelines can help health care providers to assess current practices and integrate new technological advances. Since AIDS was first recognized nearly 20 years ago, remarkable progress has been made in improving the quality and duration of life for HIV+ patients. In this area, clinical guidelines have been developed to manage patient care, focusing on: antiretroviral therapy, prevention of opportunistic infections, and treatment of tuberculosis. The quality of the guideline is notable when appropriate methodologies are applied. Different methods for developing guidelines are evaluated here: Agency for Health Care Policy and Research (AHPCR) methodology is designed to produce evidence-based guidelines that are valid, clinically applicable, and flexible. Finally, the problems associated with the implementation of guidelines for HIV-related diseases and other infectious diseases are examined.
Lauria
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FN
Direzione Sanitaria, Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani-IRCCS, Rome, Italy. lauria@spallanzani.roma.it
Vanacore
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P
Casciello
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M
D015658:HIV Infections / Q000150:complications* / Q000628:therapy*; D006801:Humans; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D014481:United States; D016270:United States Agency for Healthcare Research and Quality