title: Development of a South African integrated syndromic respiratory disease guideline for primary care.
abstract: OBJECTIVE
  The Practical Approach to Lung Health in South Africa (PALSA) initiative aimed to develop an integrated symptom- and sign-based (syndromic) respiratory disease guideline for nurse care practitioners working in primary care in a developing country.
  
  
  METHODS
  A multidisciplinary team developed the guideline after reviewing local barriers to respiratory health care provision, relevant health care policies, existing respiratory guidelines, and literature. Guideline drafts were evaluated by means of focus group discussions. Existing evidence-based guideline development methodologies were tailored for development of the guideline.
  
  
  RESULTS
  A locally-applicable guideline based on syndromic diagnostic algorithms was developed for the management of patients 15 years and older who presented to primary care facilities with cough or difficulty breathing.
  
  
  CONCLUSIONS
  PALSA has developed a guideline that integrates and presents diagnostic and management recommendations for priority respiratory diseases in adults using a symptom- and sign-based algorithmic guideline for nurses in developing countries.
authors.affiliation: Knowledge Translation Unit, University of Cape Town Lung Institute, Cape Town, South Africa. renglish@pgwc.gov.za
authors.forename: René G
authors.initials: RG
authors.lastname: English
authors.forename: Eric D
authors.initials: ED
authors.lastname: Bateman
authors.forename: Merrick F
authors.initials: MF
authors.lastname: Zwarenstein
authors.forename: Lara R
authors.initials: LR
authors.lastname: Fairall
authors.forename: Angeni
authors.initials: A
authors.lastname: Bheekie
authors.forename: Max O
authors.initials: MO
authors.lastname: Bachmann
authors.forename: Bosielo
authors.initials: B
authors.lastname: Majara
authors.forename: Salah-Eddine
authors.initials: SE
authors.lastname: Ottmani
authors.forename: Robert W
authors.initials: RW
authors.lastname: Scherpbier
mesh_terms: D000465:Algorithms; D003371:Cough / Q000209:etiology; D004417:Dyspnea / Q000209:etiology; D006801:Humans; D010348:Patient Care Team; D017410:Practice Guidelines as Topic; D011320:Primary Health Care; D012140:Respiratory Tract Diseases / Q000175:diagnosis* / Q000628:therapy*; D013019:South Africa