title: Effects of clinical pathways for chronic obstructive pulmonary disease (COPD) on patient, professional and systems outcomes: protocol for a systematic review.
abstract: Chronic obstructive pulmonary disease (COPD) is a respiratory syndrome characterized by progressive, partially reversible airway obstruction and lung hyperinflation. COPD has a substantial burden which is seen in both patient quality of life and healthcare costs. One proposed method of minimizing this burden is the implementation of clinical pathways (CPWs). CPWs aim to guide evidence-based practice and improve the interaction between health services. They bring the best available evidence to a range of healthcare professionals by adapting evidence-based clinical guidelines to a local context and detailing the essential steps in the assessment and care of patients.
  
  
  
  The aim of this systematic review is to synthesize existing literature on the effects of CPWs for the treatment or management of COPD. We will screen search hits from search strategies developed for a Cochrane Effective Practice and Organisation of Care (EPOC) systematic review on the use of CPWs in primary care and a Cochrane EPOC review on the use of CPWs in hospitals. These searches were run in a range of databases. Studies will be screened independently by two reviewers. All studies identified by our search strategy will be considered regardless of study design as long as they meet the operational definition for clinical pathways developed by Kinsman et al. (BMC Medicine 8, 2010) and focus on the treatment or management of COPD. All included studies will be evaluated for risk of bias utilizing methodologies set out by the Cochrane collaboration. Data regarding patient, professional and systems outcomes will be extracted from all included studies. Data will be presented in both narrative and tabular form.
  
  
  
  The systematic review outlined in this protocol aims to identify, assess and synthesise all available evidence on the effects of CPWs regarding the treatment and management of COPD. As a result, this review will provide an evidence base for decision makers regarding the practicality, cost effectiveness, patient benefit and best practices regarding the implementation of CPWs for the care of COPD.
authors: College of Pharmacy and Nutrition, University of Saskatchewan, E3315 Health Sciences Building, Saskatoon, SK S7N 5E5, Canada. chris.plishka@usask.ca.
authors: Christopher
authors: 0000-0003-0157-2409
authors: C
authors: Plishka
authors: College of Pharmacy and Nutrition, University of Saskatchewan, E3315 Health Sciences Building, Saskatoon, SK S7N 5E5, Canada.
authors: Thomas
authors: T
authors: Rotter
authors: University of Tasmania and Tasmanian Health Organisation (North), Launceston, Tasmania, Australia.
authors: Leigh
authors: L
authors: Kinsman
authors: Regina Qu'Appelle Health Region, Regina, Canada.
authors: Mohammed Rashaad
authors: MR
authors: Hansia
authors: College of Pharmacy and Nutrition, University of Saskatchewan, E3315 Health Sciences Building, Saskatoon, SK S7N 5E5, Canada.
authors: Adegboyega
authors: A
authors: Lawal
authors: College of Medicine, University of Saskatchewan, Saskatoon, Canada.
authors: Donna
authors: D
authors: Goodridge
authors: College of Medicine, University of Saskatchewan, Saskatoon, Canada.
authors: Erika
authors: E
authors: Penz
authors: Respirology, Critical Care and Sleep Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Canada.
authors: Darcy D
authors: DD
authors: Marciniuk
mesh_terms: D003266:Continuity of Patient Care; D019091:Critical Pathways; D003695:Delivery of Health Care / Q000379:methods*; D006282:Health Personnel; D006296:Health Services; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D012107:Research Design; D000078202:Systematic Reviews as Topic
keywords: COPD; Care maps; Care pathways; Chronic obstructive pulmonary disease; Clinical pathways; Critical pathways; Integrated care pathways