Evidence map›Paper›PMID 42485647›Full record

ArticleFamily practice2026

From guidelines to practice: general practitioners' consensus on indicators for managing selected multimorbidity in primary care in Western Australia.

Sage M C Ishimwe, Timothy A Carey, Jacquita S Affandi, Ninh Thi Ha, Amna Mushtaq, Sayyida Anees, Christopher M Reid, Dan Xu, Delia Hendrie

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Article in Family practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Sage M C IshimweFaculty of Health Sciences, Curtin School of Population Health, Curtin University, Bentley campus, Perth, Western Australia 6102, Australia.ORCID 0000-0001-9928-5891
Timothy A CareyCentre Health Equity in Regional and Remote Communities, CQUniversity, Rockhampton, Queensland 4701, Australia.
Jacquita S AffandiFaculty of Health Sciences, Curtin School of Population Health, Curtin University, Bentley campus, Perth, Western Australia 6102, Australia.
Ninh Thi HaFaculty of Health Sciences, Curtin School of Population Health, Curtin University, Bentley campus, Perth, Western Australia 6102, Australia.
Amna MushtaqFaculty of Health Sciences, Curtin School of Population Health, Curtin University, Bentley campus, Perth, Western Australia 6102, Australia.
Sayyida AneesRoyal Australian College of General Practitioners, Melbourne, Victoria 3002, Australia.
Christopher M ReidFaculty of Health Sciences, Curtin School of Population Health, Curtin University, Bentley campus, Perth, Western Australia 6102, Australia.
Dan XuFaculty of Health Sciences, Curtin School of Population Health, Curtin University, Bentley campus, Perth, Western Australia 6102, Australia.
Delia HendrieFaculty of Health Sciences, Curtin School of Population Health, Curtin University, Bentley campus, Perth, Western Australia 6102, Australia.

Funding

Medical Research Future Fund 2032129Royal Australian College of General Practitioners for the research
6 · The paper itself

Abstract

backgroundMultimorbidity is rising in primary care, yet adherence to guidelines is hindered by fragmented, disease-specific recommendations. This study sought to establish consensus among general practitioners (GPs) on indicators of adherence to Australian guidelines in managing five common chronic conditions [type 2 diabetes mellitus (T2DM), obesity, hypertension, cardiovascular disease, and chronic kidney disease (CKD)], aiming to develop a unified tool for holistic care.

methodsA two-round reactive Delphi survey was conducted with 21 GPs in Western Australia, following RAND methodology. Indicators were drawn from the Royal Australian College of General Practitioners' guidelines and covered biophysical markers, lifestyle risks, and pharmacological management. Participants rated indicators for relevance and clarity on a 4-point Likert scale without a neutral option. Consensus was defined as ≥70% of GPs rating an indicator ≥3 for mean relevance. The process ended when ≥80% of indicators reached this threshold, and no new items were proposed. Feedback refined wording and, where relevant, was reported verbatim.

resultsIn Round 1, 57 indicators achieved consensus on relevance, with four additional items suggested. By Round 2, consensus was reached on 61 indicators. Most were rated clear, except two addressing pharmacological management of CKD with T2DM, which require clearer guidance. Feedback emphasized the need for refined lipid management guidelines, prioritizing obesity management for prevention, and challenges in lifestyle counselling.

conclusionThis study represents the first integration of disease-specific indicators into a GP-informed tool for multimorbidity management. Strong consensus highlights its practicality, warranting piloting to evaluate effects on guideline adherence and patient outcomes.

Indexed as

General PractitionersGuideline AdherenceMultimorbidityPractice Guidelines as TopicPrimary Health CareAdultCardiovascular DiseasesConsensusDelphi TechniqueDiabetes Mellitus, Type 2FemaleHumansHypertensionMaleMiddle AgedObesityclinical guide adherenceDeiphi surveygeneral practitionersguideline adherence indicatorsmultimorbidity care

Identifiers

PMID42485647
PMCPMC13390916

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.