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Focusing on a specific example from community care, this article argues that clinical guidelines will be better and more usable if they incorporate the findings of high-quality, qualitative research. We suggest the development and adoption of guidelines which take a holistic approach to the individual and their circumstances. These should take account of the best available evidence in terms of which treatments, devices or lifestyle changes are most effective in a particular instance, and how these are affected by the day-to-day life of patients. In so doing, clinical guidelines will become representative of the patient population to whom they relate and thus truly evidence based. We offer below one particular example of where the incorporation of qualitative evidence will improve the usability of clinical guidelines.
Pressure ulcers affect nearly half a million people in the UK in any given year.1 They can have a considerable impact on the quality of life of affected individuals,2 and are associated with an increased morbidity and mortality.3 The burden to healthcare providers is equally significant, with costs associated with pressure ulcer care believed to comprise 4% of the annual National Health Service budget.4 Evidence-based pressure ulcer prevention guidelines are available to inform clinical practice, and these recommend a range of strategies including mobilisation and repositioning, pressure redistributing support surfaces and nutritional interventions.5 6 While the risk of pressure …
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