Considering Values and Contexts in Clinical Practice Guidelines: Are We Becoming More Person-Centred?

Clinical practice guidelines (CPGs) have become ubiquitous in medicine, created to promote rational and standardized clinical decision-making. CPGs are often criticized for overlooking patient values and contexts, which many argue deserve a more explicit place in recommendations. This article explores the role of patient values and contexts in CPGs based on a critical discourse analysis of Canadian Diabetes Association (CDA) Guidelines from 1992-2013. We highlight emerging discourses related to person-centred care in CDA guidelines during this period, which support an increasing emphasis on collaboration and shared decision-making, as well as consideration of patient values and contexts. We discuss possible reasons for this shift and the implications for practitioners. Despite this encouraging trend, our analysis also suggests areas for improvement, particularly concerning the integration of patient preferences in clinical decision making and research.