BACK TO THE FUTURE: A NEW GUIDELINES PROCESS FOR HYPERTENSION CANADA AND HYPERTENSION AUSTRALIA

Objective: Guidelines have become too complex and unwieldy to be widely implemented, especially in primary care. Furthermore, a multidisciplinary approach which includes patients is needed. And, it doesn’t make sense for each country/organization to create their own guidelines – collaboration is needed. Objective: To outline a new framework for the Hypertension Canada and Hypertension Australia Guidelines.Design and method: We are led by co-chairs from each country and a steering group which includes patient partners, hypertension specialists, pharmacists, nurses, family physicians and methodologists. Results: The new collaborative guidelines approach includes 4 steps: Step 1: Primary Care Guidelines: Using the HEARTS framework, we are developing a very simple diagnosis and treatment algorithm that will apply to most patients in primary care. A robust and inclusive process will seek feedback on the guidelines from healthcare professionals. Step 2: Patient/Public Guidelines: Our patient partners are following methods put forward by the Guidelines International Network to develop public-facing guidelines to empower patients. Step 3: Priority-setting exercise to focus guideline topics: We have collated the topic areas from our previous guidelines and the ESH and ESC guidelines and are sending them to our members/interestholders to prioritize the most important topics for review/update. Step 4: “Living” Comprehensive Guidelines: We will conduct reviews of recent guidelines and conduct evidence syntheses for the identified priority topics. These will be published (and updated) on a rolling basis as they become ready, rather than waiting for a single, all-inclusive document. Steps 3 and 4 will occur yearly. Status: Our Primary Care and Patient/Public guidelines will be released in 2025. Priority setting has begun and Comprehensive Guidelines topics will begin to appear in late 2025. Conclusions: We are excited to embark on this new process, which is a balance of pragmatic and evidence-based, more discipline inclusive, and with 2 countries collaborating to improve harmonization of guidelines and avoid duplication of effort (and reduce costs).