Photo By Staff Sgt. Shelby Pruitt-Johnson | U.S. Air Force Maj. Benjamin Rud, a doctor assigned to 355th Medical Group,...... read more read more
Subscribe
Department of Defense and Department of Veterans Affairs clinical practice guidelines aim to provide the most recent and accurate evidence-based information to DOD and VA providers.
• For providers, CPGs give them the information needed to diagnose and treat particular medical conditions that may show up in the patient populations they serve.
• For patients, CPGs give them current, understandable information needed to make decisions about their health care.
Researchers have published 28 Clinical Practice Guidelines to date. VA and DOD experts create, maintain, and periodically update these CPGs as new evidence-based research emerges and further advancements in medicine evolve, covering diverse topics.
“The hardest part is keeping up with the advancement in medicine and educating the field and maintaining a standardized approach in the continuum of care for military and veteran communities across both health systems,” said Jenifer Meno, who holds a doctorate of nursing practices, and is the Defense Health Agency deputy chief, Clinical Quality Improvement Program, Medical Affairs/Clinical Support Division.
The multifaceted guidelines “are used globally and liked for their rigor in the systematic review of the literature,” said Meno. She emphasized how the care workflow of each CPG is easy to follow for clinicians and provides clinical support tools that assist with applying the recommendations that support both clinician and patients in shared decision-making.
The CPGs also offer clinical support tools that care teams can use for patient education and provider support. These tools include pocket guides, links to videos, and publications, said Meno.
In the 1990’s, the VA solely published documents similar to today’s CPGs. The Military Health System began planning and implementing broad-scale healthcare reform initiatives in response to the National Defense Authorization Act for Fiscal Year 2017 and additional guidance that followed in the NDAAs for fiscal years 2018–2020.
The current VA-DOD CPG partnership issued its first jointly developed guideline, Management of Posttraumatic Stress Disorder, in 2004. The partnership published three updates on this topic, with the latest in 2023.
So far in 2025, the partnership has published CPGs including:
• Rehabilitation of Lower Limb Amputation on Jan. 13, 2025
• Management of Chronic insomnia Disorder and Obstructive Sleep Apnea on Feb. 26, 2025
• Primary Care Management of Asthma on March 26, 2025
• Primary Care Management of Chronic Kidney Disease on May 16, 2025.
What’s Next
Several new or updated CPGs are currently being developed, including:
• Diagnosis and Management of Hypertension, projected release August 2026
• Management of Adult Obesity and Overweight, projected release August 2025
• Management of Dyslipidemia, projected release September 2025
• Tobacco Cessation, projected release March 2026
• Nonsurgical Management of Hip and Knee Osteoarthritis, projected release May 2026
• Pressure Injury Prevention (bed sores), projected release June 2026
• Menopause Management, projected release August 2026
The CPGs dealing with obesity and overweight will align with Secretary of Defense Pete Hegseth’s March 12, 2025, directive requiring service members to remain physically fit to keep U.S. forces in peak condition and readiness.
Key Aspects of VA-DOD CPGs
Each CPG promotes evidence-based practice, optimizes patient outcomes, and reduces inappropriate variations in care. Each CPG includes:
• Systematic reviews of clinical and disease prevention and protection evidence
• Multidisciplinary and expert medical and scientific input
• Critical decision points and the rationale behind them
• Regular updates based on new evidence and best practices
Writing a Value-based CPG
Together, the DOD and VA create and monitor the CPGs for value and effectiveness. A new or updated CPG can take 18 to 24 months to develop and get published, Meno said.
The VA-DOD Health Executive Committee chartered the VA-DOD Evidence-Based Practice Working Group in 2003. The group is comprised of volunteer DOD and VA multi-disciplinary clinicians providing a holistic view of care. Four to five new CPGs are considered by the group each year and the schedule for fiscal year development and updates is set by the group, Meno said.
According to a Jan. 24, 2024, information paper on CPG development by the DHA’s Clinical Quality Improvement Program, existing CPGs are looked at first by the group, especially those where meaningful advancements have been made in science, and then older CPGs are looked at for a possible refresh.
Next, the VA and DOD put together a VA-DOD CPG working group. The VA and the DOD each recruit two champions and eight clinicians from many healthcare disciplines, who they strictly vet for their expertise and lack of any conflicts of interest.
Key Questions and Recommendations Development
The CPG working group schedules a kickoff meeting, followed later in the process by a recommendation development meeting. The DOD and VA also sponsor patient focus groups to understand what matters most to patients and their caregivers.
At kickoff, the subject matter experts define the target patient population and medical audiences for the guideline. They create a large set of key questions to guide literature searches and evidence reviews.
According to Meno, the recommendation development team conducts a multi-day event that seeks to answer whether the recommendations based on the key questions are actionable—Do they work? And, how strong is the scientific evidence?
For a new CPG, the group develops key questions from the ground up. For updates to existing guidelines, the group determines if the CPG aligns with current best practices. The group may also create a new set of key questions.
The team writes three drafts. The reviewers send the third draft for outside peer review, after which the VA-DOD Evidence-Based Working Group receives the final guideline for decision. Once the members approve a CPG, the team creates provider and patient clinical support tools, such as pocket and patient guides. The team publishes approved CPGs and clinical support tools on DHA and VA websites.
“Together, the DOD and VA aim for adaptable, transparent, consistent, high-quality health care that encourages shared decision-making with patients and clinicians. This improves clinical outcomes and patient satisfaction while reducing the potential for harm and optimizing the use of resources,” Meno said.
| Date Taken: | 06.26.2025 |
| Date Posted: | 06.26.2025 13:59 |
| Story ID: | 501602 |
| Location: | US |
| Web Views: | 43 |
| Downloads: | 1 |
This work, Clinical Practice Guidelines: An Evidence-Based Tool for Providers and Patients, must comply with the restrictions shown on https://www.dvidshub.net/about/copyright.
No keywords found.
