VA/DOD Clinical Practice Guidelines Home

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class="slider-info"> <h3>2024 is Year of the Provider</h3> <p>Healthcare Providers throughout the VA have contributed immensely in the development and updates to all our CPGs. View CPG鈥檚 below.</p> <p><a tabindex="-1" href="/index.asp">Learn more »</a></p> </div> </div> <div class="slide"> <a href="mailto:vhacocpgweb@va.gov?Subject=Your Opinion Counts" tabindex="-1"> <img src="/images/surveySpotlight.png" alt="CPG Cover Image for survey with spotlights" title="Your opinion counts!" /> </a> <div class="slider-info"> <h3>Your opinion counts!</h3> <p>If you have any suggestions referencing the clinical practice guidelines please send us an email and share your thoughts.</p> <p><a tabindex="-1" href="mailto:vhacocpgweb@va.gov?Subject=Your Opinion Counts">Learn more »</a></p> </div> </div> <div class="slide"> <a href="/about/index.asp" tabindex="-1"> <img src="/images/cpgBanner3.png" alt="VA/DOD CPG Logo" title="About VA/DOD CPG" /> </a> <div class="slider-info"> <h3>About VA/DOD CPG</h3> <p>The Evidence-Based Practice Work Group selects topics for implementation of evidence-based...</p> <p><a tabindex="-1" href="/about/index.asp">Learn more »</a></p> </div> </div> </div> </div> <a class="next"><img title="next slide" alt="next slide" src="/va_files/2014/responsive/images/arrow-right.png"></a>  <div class="slider-thumbnails"> <div class="thumbnails-wrap"> <a class="selected" target="_self" href=""> <span>Year of the Provider</span> </a> <a class="" target="_self" href=""> <span>Your opinion counts!</span> </a> <a class="" target="_self" href=""> <span>About VA/DOD CPG</span> </a> </div> </div> </div> </div>   <div class="row"> <div class="col-md-12"> <span style="position:absolute;"><a id="main-content"> </a></span> <div id="homeinnerContent">   <p>VHA, in collaborations with the Department of Defense (DOD) and other leading professional organizations, has been developing clinical practice guidelines since the early 1990s. In 2010 the Institute of Medicine identified VA/DOD as leaders in clinical practice guideline development.</p> <p>Implementation of evidence-based clinical practice guidelines is one strategy VHA has embraced to improve care by reducing variation in practice and systematizing “best practices”. Guidelines address patient cohorts, serve to reduce errors, and provide consistent quality of care and utilization of resources throughout and between the VA and DOD health care systems. Guidelines are also cornerstones for accountability and facilitate learning and the conduct of research. The guidelines on this site are those endorsed by the VA/DOD Evidence Based Practice Work Group.</p> <p>Here is a link to our Department of Defense (DOD) colleagues website: <a href="https://health.mil/Military-Health-Topics/Access-Cost-Quality-and-Safety/VADOD-CPGs" target="_blank" title="Link to Defense Health Agency (DHA) Clinical Quality Improvement Program">Defense Health Agency (DHA) Clinical Quality Improvement Program</a>.</p>   <div id="tabContent"> <div class="tab-accord" id="tab-accord"> <h3 class="tab"><a href="#" class="m" role="button">Guidelines</a></h3> <h3 class="tab"><a href="#" class="m" role="button">What's New!</a></h3> <h3 class="tab"><a href="#" class="m" role="button">CPG Resources </a></h3> <div class="pane"> <h3><img src="/images/VADoDLogo2011_Tab.png" alt="VA DoD Logo" width="180" height="130" class="imagespace">Guidelines</h3>  <p>Clinical practice guidelines are used in health care to improve patient care as a potential solution to reduce inappropriate variations in care. Guidelines should be evidence based, incorporate patient input, as well as explicit criteria to ensure internal validity.</p> <p>The use of guidelines must always be in the context of a health care provider's clinical judgment in the care of a particular patient. For this reason, the guidelines may be viewed as an educational tool to provide information in shared decision making.</p> <p><a href="https://web.microsoftstream.com/video/8773b34e-3510-42dc-9bb0-9df7f9a6638a" target="_blank" title="Watch 'An Introduction to VA/DOD Clinical Practice Guidelines' on Microsoft Stream">Watch 'An Introduction to VA/DOD Clinical Practice Guidelines' | Microsoft Stream</a></p> <div class="cpg-row"> <div class="containerCell"><span class="cpgNewDoc">*** Update of CPG in Progress</span></div> </div> <div class="cpg-row"> <div class="two-column"> <div class="containerCell"> <div class="cpg-row"> <div class="cell header">Chronic Disease in Primary Care</div> </div> <div class="cpg-row"> <div class="cell data"> <div class="inner-row"><a href="/guidelines/CD/asthma/index.asp" title="Asthma"> Asthma </a> <span class="cpgNewDoc">***</span></div> <div class="inner-row"><a href="/guidelines/CD/insomnia/index.asp" title="Chronic Insomnia Disorder and Obstructive Sleep Apnea (Insomnia/OSA)"> Chronic Insomnia Disorder and Obstructive Sleep Apnea (Insomnia/OSA) </a> <span class="cpgNewDoc">***</span></div> <div class="inner-row"><a href="/guidelines/CD/ckd/index.asp" title="Chronic Kidney Disease (CKD)"> Chronic Kidney Disease (CKD) </a> <span class="cpgNewDoc">***</span></div> <div class="inner-row"><a href="/guidelines/MR/cmi/index.asp" title="Management of Chronic Multisymptom Illness (CMI)"> Management of Chronic Multisymptom Illness (CMI) </a></div> <div class="inner-row"><a href="/guidelines/CD/copd/index.asp" title="Chronic Obstructive Pulmonary Disease (COPD)"> Chronic Obstructive<br />Pulmonary Disease (COPD) </a></div> <div class="inner-row"><a href="/guidelines/CD/diabetes/index.asp" title="Diabetes Mellitus (DM)"> Diabetes Mellitus (DM) </a></div> <div class="inner-row"><a href="/guidelines/CD/lipids/index.asp" title="Dyslipidemia (LIPIDS)"> Dyslipidemia (LIPIDS) </a></div> <div class="inner-row"><a href="/guidelines/CD/htn/index.asp" title="Hypertension (HTN)"> Hypertension (HTN) </a></div> <div class="inner-row"><a href="/guidelines/CD/OA/index.asp" title="The Non-Surgical Management of Hip & Knee Osteoarthritis (OA)"> The Non-Surgical Management of Hip & Knee Osteoarthritis (OA) </a></div> <div class="inner-row"><a href="/guidelines/CD/obesity/index.asp" title="Obesity and Overweight (OBE)"> Obesity and Overweight (OBE) </a></div> <div><a href="/guidelines/CD/tinnitus/index.asp" title="Tinnitus"> Tinnitus </a></div> </div> </div> </div> </div> <div class="two-column"> <div class="containerCell"> <div class="cpg-row"> <div class="cell header">Mental Health</div> </div> <div class="cpg-row"> <div class="cell data"> <div class="inner-row"><a href="/guidelines/MH/bd/index.asp" title="Bipolar Disorder (BD)"> Bipolar Disorder (BD) </a></div> <div class="inner-row"><a href="/guidelines/MH/scz/index.asp" title="Management of First-Episode Psychosis and Schizophrenia (SCZ)"> Management of First-Episode Psychosis and Schizophrenia (SCZ) </a></div> <div class="inner-row"><a href="/guidelines/MH/mdd/index.asp" title="Major Depressive Disorder (MDD)"> Major Depressive Disorder (MDD) </a></div> <div class="inner-row"><a href="/guidelines/MH/ptsd/index.asp" title="Posttraumatic Stress Disorder (PTSD)"> Posttraumatic Stress Disorder (PTSD) </a></div> <div class="inner-row"><a href="/guidelines/MH/srb/index.asp" title="Assessment and Management of Patients at Risk for Suicide"> Assessment and Management of Patients at Risk for Suicide </a></div> <div><a href="/guidelines/MH/sud/index.asp" title="Substance Use Disorder (SUD)"> Substance Use Disorder (SUD) </a></div> </div> </div> </div> </div> </div> <div class="cpg-row"> </div> <div class="cpg-row"> <div class="three-column"> <div class="containerCell"> <div class="cpg-row"> <div class="cell header">Pain</div> </div> <div class="cpg-row"> <div class="cell data"> <div class="inner-row"><a href="/guidelines/Pain/headache/index.asp" title="Headache"> Headache </a></div> <div class="inner-row"><a href="/guidelines/Pain/lbp/index.asp" title="Lower Back Pain (LBP)"> Lower Back Pain (LBP) </a></div> <div><a href="/guidelines/Pain/cot/index.asp" title="Opioid Therapy (OT) for Chronic Pain"> Use of Opioids in the Management of Chronic Pain </a></div> </div> </div> </div> </div> <div class="three-column"> <div class="containerCell"> <div class="cpg-row"> <div class="cell header">Rehabilitation</div> </div> <div class="cpg-row"> <div class="cell data"> <div class="inner-row"><a href="/guidelines/Rehab/amp/index.asp" title="Lower Limb Amputation"> Lower Limb Amputation </a> <span class="cpgNewDoc">***</span></div> <div class="inner-row"><a href="/guidelines/Rehab/mtbi/index.asp" title="Concussion-mTBI"> Management and Rehabilitation of Post-Acute Mild Traumatic Brain Injury (mTBI) </a></div> <div class="inner-row"><a href="/guidelines/Rehab/stroke/index.asp" title="Stroke Rehabilitation"> Stroke Rehabilitation </a></div> <div><a href="/guidelines/Rehab/ULA/index.asp" title="The Management of Upper Limb Amputation Rehabilitation (ULA)"> The Management of Upper Limb Amputation Rehabilitation (ULA) </a></div> </div> </div> </div> </div> <div class="three-column"> <div class="containerCell"> <div class="cpg-row"> <div class="cell header">Women's Health</div> </div> <div class="cpg-row"> <div class="cell data"> <div><a href="/guidelines/WH/up/index.asp" title="Pregnancy"> Pregnancy </a></div> </div> </div> </div> </div> </div> <p>Retired CPG's can be found on our <a href="/CPGArchives.asp" title="Archive Page"> archive page </a></p>  </div> <div class="pane"> <h3><img src="/images/cpgWhatsNew.png" alt="What's New in VA/DoD CPG" width="180" height="130" class="imagespace">What's New!</h3>  <p class="cpg-paragraph-header">New and Newly Updated Evidence Based Clinical Practice Guidelines (CPG) and Associated Tools</p> <ul class="cpg-bold" style="margin-top: 35px; margin-bottom: 18px; display: inline-block;"> <li><span class="cpgNewDoc">NEW</span> Tinnitus (2024)</li> <li>Assessment and Management of Patients at Risk for Suicide (2024)</li> <li>Management of Stroke (2024)</li> </ul> <p>The VA and Department of Defense (DOD) have collaboratively developed evidence-based clinical practice guidelines since the 1990s.</p> <p>The CPGs provide information that is evidence-based and unbiased by conflict of interest. They are based on the best available evidence at the date of publication, and are intended to provide a general guide to best practices.</p> <p>These guidelines can assist healthcare providers, but the use of a CPG must always be considered as a recommendation, within the context of a provider’s clinical judgment, for the care of an individual patient.</p> <p class="cpg-paragraph-header">Listed below are the Updated CPG links:</p> <ul style="margin-top: 4px; margin-bottom: 12px;"> <li><span class="cpgNewDoc">NEW</span>  <a href="/guidelines/CD/tinnitus/index.asp" title="Tinnitus (2024)">Tinnitus (2024)</a></li> <li><a href="/guidelines/MH/srb/index.asp" title="Assessment and Management of Patients at Risk for Suicide (2024)"> Assessment and Management of Patients at Risk for Suicide (2024) </a></li> <li><a href="/guidelines/Rehab/stroke/index.asp" title="Management of Stroke (2024)"> Management of Stroke (2024) </a></li> </ul> <p>VA/DOD CPGs are recognized nationally and internationally as exemplars, and their quality speaks for itself. The Director of the Evidence-Based Practice Program, Dr. James Sall, recognizes that the tremendous dedication, time, expertise, and energy of the work group members are entirely responsible for the quality reputation of our CPGs. He sincerely thanks the Champions and Work Group members for providing our health care teams with the tools for providing Veterans optimal evidence-based care.</p>  </div> <div class="pane"> <h3><img src="/images/cpgResources.png" alt="CPG resources " width="180" height="130" class="imagespace">CPG Resources </h3>  <ul class="no-disk"> <li><a href="https://online.epocrates.com/guidelines" title="link to Epocrates (Online Guidelines)" class="link">Epocrates (Online Guidelines)</a></li> <li><a href="http://www.hsrd.research.va.gov/publications/esp/" title="link to Evidence-Based Synthesis Program" class="link"> Evidence-Based Synthesis Program </a></li> <li><a href="http://www.ahrq.gov/clinic/prevenix.htm" title="link to Guide to US Preventive Service Task Force" class="link"> Guide to US Preventive Service Task Force </a></li> <li><a href="http://www.pbm.va.gov/" title="link to Pharmacy Benefits Management (VA)" class="link">Pharmacy Benefits Management (VA)</a></li> <li><a href="http://www.prevention.va.gov/" title="link to VHA Preventive Health" class="link">VHA Preventive Health</a></li> </ul> <p>The following sites provide additional information on evidence-based clinical practice:</p> <ul class="no-disk"> <li><a href="http://www.queri.research.va.gov/" title="QUERI - VA/HSR&D Quality Enhancement Research Initiative">QUERI</a> - VA/HSR&D Quality Enhancement Research Initiative - which works to improve the quality of health care for veterans by implementing research findings into routine practice</li> <li><a href="https://guidelines.ecri.org/" target="_blank" title="ECRI Guideline Trust. Link opens to a resource outside the VA">ECRI Guideline Trust</a>* is a public resource for disseminating evidence-based clinical practice guidelines</li> <li><a href="http://www.myhealth.va.gov/" title="MyHealthE Vet">MyHealthE Vet</a> is the VA on-line personal health record that allows veterans to access their own health information as well as a wealth of patient education materials</li> <li><a href="https://health.mil/Military-Health-Topics/Access-Cost-Quality-and-Safety/VADOD-CPGs" target="_blank" title="Defense Health Agency Medical Affairs/Clinical Support Division. Link opens to a resource outside the VA">Defense Health Agency Medical Affairs/Clinical Support Division</a>* is the world-wide contact point for clinical guidelines used by all branches of the service</li> </ul> <p>* Links will take you outside the VA/DOD CPG web site. 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