Integrating Qualitative Evidence in Practice Guideline Development

Abstract

The production of practice guidelines is a relatively recent development in social work. Because of their antecedents in evidence-based medicine, methods for producing guidelines have been dominated by quantitative approaches to systematic reviewing with relatively little attention given to the integration of qualitative forms of knowledge. The under-representation of qualitative research, and dependence on meta-analysis of randomised controlled trials, threatens to marginalize important perspectives such as process and implementation data, as well as the voice of service users. Increasing integration of health and social care services also requires that practice guidance incorporates forms of knowledge that are relevant to social care. This article describes methods used to develop the first two national practice guidelines for England and Wales (for dementia care and parent-education/training programmes) produced jointly by the Social Care Institute for Excellence and National Institute for Clinical and Health Excellence. These guidelines demonstrate innovation in their approaches to incorporation of qualitative perspectives. Implications of these two exemplars are considered for future guideline development.