Background: Involving guideline users during the development of a guideline increases the likelihood that the guideline will be implemented. This is because an inclusive approach highlights the needs of users and the contextual factors that might influence implementation. Our team is creating a clinical guideline entitled 'Clinical guideline for the diagnosis and management of work-related mental health conditions in general practice', in response to increasing commitment from compensation schemes to improve patient outcomes. However, GPs are a challenging cohort for guideline implementers to influence. One potential way to increase the likelihood of guideline uptake by GPs is to create key questions based on the Clinical Reasoning Framework, which is the systematic approach that GPs use to investigate and manage symptoms.

Objective: To apply a user-centred approach, involving the Clinical Reasoning Framework for the development of key questions for the work-related mental health guideline for GPs.

Methods: International best-practice approaches were used to create the overarching process for development of key questions. We then integrated steps to obtain and organise clinical perspectives of GPs into this process.

Results: A seven-step approach to the development of the guideline questions was created. These are: 1) Define the rationale for the guideline; 2) Generate an initial list of questions based on qualitative interviews with primary end-users (GPs) and secondary end-users (psychiatrists and compensation scheme workers), and extend these findings with a literature review. Qualitative data was analysed using the Clinical Reasoning Framework to; 3) Define the key questions; 4) List the relevant outcomes; 5) Review and revise the draft key questions; 6) Prioritise draft key questions; and, 7) Decide on the final list of key questions.

Conclusions: The Clinical Reasoning Framework can be used as an innovative approach to determine guideline questions for GPs.