Health equity considerations in guideline development: a rapid scoping review

Abstract

Background: Systematic guidance for considering health equity in guidelines is lacking. This scoping review aims to synthesize current best practices for integrating health equity into guideline development and the benefits or drawbacks of these practices. Methods: We searched Ovid MEDLINE ALL and Embase Classic+Embase on the Ovid platform, CINAHL on EBSCO, and Web of Science (Core Collection) from 2010 to 2022. We searched grey literature from 2015 to 2022, using the Canadian Agency for Drugs and Technologies in Health Grey Matters checklist and searches of potentially relevant websites. Articles were screened independently by 1 reviewer. Proposed best practices, advantages and disadvantages, and tools were extracted independently by 1 reviewer and qualitatively synthesized based on the relevant steps of a comprehensive checklist covering the stages of guideline development. Results: We included 26 articles that proposed best practices for incorporating health equity within the guideline development process. These practices were organized under different stages of the development process, including guideline planning, evidence review, guideline development and dissemination. Included studies provided best practices from guideline producers, articles discussing health equity in current guidelines, articles addressing strategies to increase equity in the guideline implementation process, and literature reviews of promising health equity practices. Interpretation: Our scoping review identified best practices to incorporate health equity considerations at each phase of guideline development. Identified practices may be used to inform equity-promoting strategies with the guideline development process; however, guideline producers should carefully consider the advantages and disadvantages of best practices when integrating health equity.

Recommandations pour des soins préventifs pour promouvoir l’équité en matière de santé

“…La reprise des activités en période postpandémique est une occasion d'apporter des changements, d'orienter les soins de santé vers la promotion de l'équité et d'éviter les iniquités décriées durant la pandémie 32 . Les principales orientations concernant les soins préventifs n'ont pas mis l'accent sur la promotion de l'équité en matière de santé, mais les comités de rédaction reconnaissent l'importance de lutter contre les iniquités 33,34 .…”

Preventive care recommendations to promote health equity

“…32 Prominent guidance on preventive care has not focused on promoting health equity, although guideline producers recognize the importance of addressing inequities. 33,34 We identified an opportunity to provide recommendations for preventive care that could address inequities, with input from patients and those with lived experiences of disadvantages. Preventive care services can be oriented to counter rather than amplify systemic inequities.…”