An interpretive description of health equity in chronic obstructive pulmonary disease (COPD) clinical practice guidelines
Date
2023-06-21
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Health equity is an increasing global phenomenon of interest among health care professionals
(HCPs), researchers, and decision-makers. Clinical practice guidelines (CPGs) serve to promote
standardized care and may have implications relative to health equity. Health care professionals
rely on evidence including CPGs to be accountable, provide optimal care, and to advance
advocacy efforts for people with chronic lung disease. However, CPGs for COPD may
unintentionally exacerbate health inequities and health disparities experienced by those living in
northern or rural areas where there may be decreased access to supports such as spirometry,
pulmonary rehabilitation, and specialist care. The purpose of this study was to conduct an
interdisciplinary analysis of COPD CPGs to understand the contribution and implications of
these guidelines to health equity for individuals living with COPD. Different perspectives and
representations of health equity across the guidelines may have problematic implications and
challenges for patients, HCPs and decision-makers. The research question guiding this study is
how do CPGs for COPD explicitly or implicitly address health equity? The study design,
interpretive description, was guided by critical social theory. Using purposive sampling, publicly
available international, national, and provincial English language CPGs for COPD were selected.
Concurrent data collection and analysis was informed by five items of The Equity Lens
instrument and the four items of Domain 5, outlined in the Applicability of the Appraisal of
Guidelines for Research & Evaluation II (AGREE II) Instrument. The four stages of content
analysis are decontextualization, recontextualization, categorization, and compilation. The results
offer opportunities to engage multiple interdisciplinary knowledge users in dialogue about the
implications of CPG adoption to move toward health equity and to best service individuals with
COPD in Northeastern Ontario.
Description
Keywords
Chronic obstructive pulmonary disease,, COPD,, health equity,, clinical practice guidelines,, interpretive description,, social determinants of health