TY - JOUR T1 - Guideline harmonization and implementation plan for the BETTER trial: Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Family Practice JF - CMAJ Open SP - E1 LP - E10 DO - 10.9778/cmajo.20130040 VL - 2 IS - 1 AU - Denise Campbell-Scherer AU - Jess Rogers AU - Donna Manca AU - Kelly Lang-Robertson AU - Stephanie Bell AU - Ginetta Salvalaggio AU - Michelle Greiver AU - Christina Korownyk AU - Doug Klein AU - June C. Carroll AU - Mel Kahan AU - Jamie Meuser AU - Sandy Buchman AU - Rebekah M. Barrett AU - Eva Grunfeld Y1 - 2014/01/22 UR - http://www.cmajopen.ca/content/2/1/E1.abstract N2 - Background The aim of the Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Family Practice (BETTER) randomized controlled trial is to improve the primary prevention of and screening for multiple conditions (diabetes, cardiovascular disease, cancer) and some of the associated lifestyle factors (tobacco use, alcohol overuse, poor nutrition, physical inactivity). In this article, we describe how we harmonized the evidence-based clinical practice guideline recommendations and patient tools to determine the content for the BETTER trial. Methods We identified clinical practice guidelines and tools through a structured literature search; we included both indexed and grey literature. From these guidelines, recommendations were extracted and integrated into knowledge products and outcome measures for use in the BETTER trial. End-users (family physicians, nurse practitioners, nurses and dieticians) were engaged in reviewing the recommendations and tools, as well as tailoring the content to the needs of the BETTER trial and family practice. Results In total, 3–5 high-quality guidelines were identified for each condition; from these, we identified high-grade recommendations for the prevention of and screening for chronic disease. The guideline recommendations were limited by conflicting recommendations, vague wording and different taxonomies for strength of recommendation. There was a lack of quality evidence for manoeuvres to improve the uptake of guidelines among patients with depression. We developed the BETTER clinical algorithms for the implementation plan. Although it was difficult to identify high-quality tools, 180 tools of interest were identified. Interpretation The intervention for the BETTER trial was built by integrating existing guidelines and tools, and working with end-users throughout the process to increase the intervention’s utility for practice. Trial registration: ISRCTN07170460 ER -