| Clinical healthcare example | CPG maintenance scenario |
---|---|---|
Target condition | Arterial hypertension is present (≥ 140/90 mmHg) | The recommendation is outdated (There was new peer-reviewed scientific evidence published) |
Objective | To choose an appropriate management option in the presence of the target condition using the information gathered from staging | To choose an appropriate management option in the presence of the target condition using the information gathered from staging |
Management option #1, when: indications | Advice on lifestyle changes, when: Grade 1 blood pressure AND low to moderate cardiovascular risk profile without cardiovascular disease, renal disease, or hypertension-mediated organ damagea | Update the recommendation, when: New evidence is very likely cause changes in the strength of the recommendation OR new evidence is very likely cause changes in the direction of the recommendation OR new evidence indicates a new recommendation should be added OR new evidence indicates an existing recommendation should be removeda |
Management option #2, when: indications | Advice on lifestyle changes and drug prescription after 3–6 months, when: Grade 1 blood pressure AND low to moderate cardiovascular risk profile without cardiovascular disease, renal disease, or hypertension-mediated organ damage AND blood pressure was not controlled after 3–6 months of lifestyle interventionsa | Do not update the recommendation, but reassess at a later point in time, when: The new evidence is very unlikely or somewhat unlikely to cause changes in the strength or direction of the recommendation OR no new evidence was found OR a valid justification is provided to postpone an updatea |
Management option #3, when: indications | Advice on lifestyle changes and immediate drug prescription, when: (Grade 1 blood pressure AND high to very high cardiovascular risk profile with cardiovascular disease, renal disease, or hypertension-mediated organ damage)a OR grade 2 blood pressure OR grade 3 blood pressure | Withdraw the recommendation, when: The clinical field signals that guidance is no longer needed OR new evidence indicates that an intervention should be de-implementeda OR registry data shows that the recommendations were fully implemented |