Table 5 Completed matrix tool for ischaemic heart diseases and diseases of the coronary artery

- Burden of disease, in terms of mortality, incidence or prevalence of disease

- Economic impact and costs

Does guideline development in this area have the potential to impact many people affected by this disease?

- Significantly improve health outcomes/promote health/reduce inequalities

- Significant or unexplained variation in clinical practice

- Feasibility of implementing a guideline

- Reduce avoidable mortality or morbidity

Would a guideline on this topic feasibly address or impact clinical practice and health outcomes and reduce variance in care?

- Relevance to our 2018–2020 Strategy

Would a guideline on this topic be on strategy for our organization?

- Topic representation during clinical themes public consultation by healthcare professionals and consumers

- Misconception about topic within the general community

Is there demonstrated feedback from our community that a guideline on this topic is needed?

- Relevance of topic to healthcare workers with a diverse level of expertise where most of the care is delivered by nonexperts

Is care in this clinical area significantly delivered by nonexperts?

- New, emerging or rapidly changing evidence or new care options

- Complexity, controversy or uncertainty about topics and treatment

- Level and quality of current evidence on topic

- Published guidelines or guidelines funded by our organization within the past 2 years already exist

Would a guideline on this have a strong evidence base or address any controversy in the interpretation of the current evidence base?

Some deaths are the first presentation—sudden cardiac death due to coronary heart disease. This disease is daily work for general practice. Enormous benefit in developing guidelines in this area with a huge scope that may span a number of guidelines. Huge impact if applied well. Scope primary and secondary care. Suggest update guidelines for primary prevention—absolute risk and hypertension in one document

If prevalence data include risk factors, this will include a lot more people

Noted ischaemic heart disease and coronary artery disease are used interchangeably; however, the latter does not cover stroke or peripheral vascular disease and is more specific to heart disease

Decide whether primary, subclinical or manifest disease

Mental health is an area of inequality and there is high prevalence in this group. Psychiatric disease and coronary artery disease need specialized care

Early-onset cognitive decline noted as another special population

Noted this is identified in our current strategy

Guidance for targeted use of aspirin needed for individuals who will truly benefit

Medication adherence, deprescribing and shared decision-making identified as areas requiring guidance/support

Misconception around statins and medication in general in patients

Guidelines on when medication can safely be withdrawn needed

Discussed intellectual commentary for general practitioners about deprescribing, duration of therapies and the evidence base around this or guidelines to include this and discuss the evidence base/impacts to align a common approach

Some components of specialist input, largely general practice

Current guidelines noted—hypertension, acute coronary syndromes and absolute risk

Noted absolute risk guidelines are being updated—will be discussing in the next 4–6 weeks, this will impact scope depending on what is covered by these guidelines

Update guidelines needed for primary prevention (like New Zealand did)

Discussion on living guidelines and Magic app—how will we update guidelines we already have?