Canadian Cardiovascular Harmonized National Guideline Endeavour (C-CHANGE) guideline for the prevention and management of cardiovascular disease in primary care: 2022 update
Rahul Jain, James A. Stone, Gina Agarwal, Jason G. Andrade, Simon Bacon, Harpreet S. Bajaj, Brian Baker, Gemma Cheng, David Dannenbaum, Mark Gelfer, Jeffrey Habert, John M. Hickey, Karim Keshavjee, Darlene Kitty, Patrice Lindsay, Mary R. L’Abbé, David C.W. Lau, Laurent Macle, Michael McDonald, Kara Nerenberg, Glen J. Pearson, Thuy Trang Pham, Alexandre Y. Poppe, Doreen M. Rabi, Diana Sherifali, Peter Selby, Eric E. Smith, Sol Stern, George Thanassoulis, Kristin A Terenzi, Karen Tu, Jacob A. Udell, Sean Virani, Richard Ward, Darren E. R. Warburton, Sean Wharton, Jennifer Zymantas, Diane Hua‐Stewart, Peter P. Liu, Sheldon W. Tobe
Abstract
The goal of the Canadian Cardiovascular Harmonized National Guideline Endeavour (C-CHANGE) process is to give all Canadian health care providers easy access to a comprehensive and practical set of harmonized guideline recommendations. Clinicians claim that there are too many guidelines with too many individual recommendations to be practical and accessible for primary care; that their patients' multimorbidity requires them to access many guidelines at the same time; and that at least in the past, some of the recommendations were not harmonized and seemed contradictory. It is designed to help clinicians formulate comprehensive treatment plans for use by all members of the health care team to address multimorbidity, as recommended by the Canadian Heart Health Strategy and Action Plan. 2 This fourth update was necessitated by recent changes to the guidelines included in previous updates and the addition of guidelines from 3 guideline groups new to the C-CHANGE process (Canadian Cardio vascular Society/Canadian Heart Rhythm Society guideline for the management of atrial fibrillation, Health Canada's Dietary Guideline and the Canadian Consensus Conference on Diagnosis and Treatment of Dementia) (Appendix 1, available at www.cmaj.ca/lookup/doi/10.1503/cmaj.220138/tab-related -content), thus increasing the comprehensiveness from the 2011, 1 2014 3 and 2018 4 versions to a total of 11 guideline groups.