Background Background The Alberta Ambassador Guideline Adaptation Programme developed two CPGs on the management of low back pain and headache in primary care. Various guideline companion documents were developed for patients.

Objectives To review the process and outcomes of involving patients/public in the development of guideline resource documents.

Methods Focus groups of different compositions and using various sampling strategies were called upon: self-selected members from national patient pain association (patient information sheets); members of the public who serve on a standing Lay Committee (patient information sheets, comic book); purposive recruitment by market research company (comic book). Participants answered questions related to the content, format, and presentation of patient resources using different interview methods.

Results Discussion themes included wordiness of documents, language accessibility, use of logos, and trustworthiness. Multiple suggestions for improvements that were sensitive to the needs of participants were considered before publication of final products. The comic book was not published.

Discussion Even though the focus group procedures varied, there was significant overlap and repetition in the feedback received on the same guideline resources. The patient focus group facilitated by a clinician engaged participants in discussions oriented to clinical issues. The comic book was considered to be a novel communication vehicle by clinicians but not so by public.

Implications for Guideline Developers/Users Involving a motivated Lay Committee facilitated by someone not directly related to the project seems to be a valuable alternative to other focus groups of patients which may require more effort and resources.