Incorporating equity into developing and implementing for evidence-based clinical practice guidelines

Rev Salud Publica (Bogota). 2011 Apr;13(2):339-51. doi: 10.1590/s0124-00642011000200015.


Clinical practice guidelines (CPG) are useful tools for clinical decision making, processes standardization and quality of care improvements. The current General Social Security and Health System (GSSHS) in Colombia is promoting the initiative of developing and implementing CPG based on evidence in order to improve efficiency and quality of care. The reduction of inequalities in health should be an objective of the GSSHS. The main propose of this analysis is to argue why it is necessary to consider the incorporation of equity considerations in the development and implementation of clinical practice guidelines based on the evidence. A series of reflections were made. Narrative description was used for showing the arguments that support the main findings. Among them are: 1. Differential effectiveness by social groups of interventions could diminish final effectiveness of CPG in the GSSHS; 2. To not consider geographical, ethnic, socioeconomic, cultural and access diversity issues within the CPG could have a potential negative impacts of the CPG; 3. Overall effectiveness of GPC could be better if equity issues are included in the quality verification checklist of the guideline questions; 4. Incorporating equity issues in the process of developing CPG could be cost effective, because improve overall effectiveness of CPG. Conclusions To include equity issues in CPG can help in achieving more equitable health outcomes. From this point of view CPG could be key tools to promote equity in care and health outcomes.

MeSH terms

  • Colombia
  • Cost-Benefit Analysis
  • Cultural Diversity
  • Evidence-Based Medicine*
  • Health Care Sector / ethics
  • Health Care Sector / standards
  • Health Services Accessibility / ethics*
  • Humans
  • Models, Theoretical
  • Outcome Assessment, Health Care
  • Practice Guidelines as Topic / standards*
  • Social Justice*
  • Socioeconomic Factors