Challenges and Stimulating Factors for the Incorporation of Economic Considerations in Clinical Practice Guidelines: A Scoping Review.

Rationale, Aims And Objectives: The incorporation of economic considerations in clinical practice guidelines (CPGs) could help promote cost-conscious decision-making in healthcare. Though healthcare expenditures increase, and resources are becoming scarcer, the extent to which economic considerations are incorporated into CPGs remains limited. This scoping review aims to identify the challenges and potential stimulating factors to incorporate economic considerations in CPGs.

Method: This scoping review was conducted following the Joanna Briggs Institute Methodology and findings were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A systematic search was conducted in eight databases considering literature published from July 2017 and onwards. Data extraction was conducted via an iterative and inductive approach to identify challenges and potential stimulating factors from the included reports. Included documents focused on the (para)medical field and reported on CPG development and economic considerations.

Results: The search identified 2445 documents from which 33 documents were included for analysis. The analysis identified five challenges: discourse surrounding economic considerations in CPGs, methodological ambiguities, scarcity of (high-quality) economic evidence, transferability of evidence, and resource constraints. Additionally, three potential stimulating factors were identified: acceptance, economic evidence knowledge, and guidance on incorporating economic considerations.

Conclusion: These findings reflect the complexity of incorporating economic considerations in CPGs. The identified challenges highlight the need for clearer guidance (i.e. by training) and standardised methodologies for incorporating economic considerations in CPGs. The potential stimulating factors provide a roadmap for future efforts to enhance the integration of economic evidence in CPGs. Collaborative initiatives between health economists, CPG developers, and other stakeholders are essential to drive progress in this area and promote cost-conscious decision-making in healthcare.