No abstract

Background and objective High quality evidence-based clinical practice guidelines (CPGs) have a major impact on the appropriate diagnosis and management and positive outcomes. The evidence-based healthcare for patients with attention deficit hyperactive disorder (ADHD) is challenging. The objective of this study was to appraise the quality of published CPGs for ADHD. Methods A systematic review was conducted for ADHD CPGs using CPG databases, DynaMed, PubMed, and Google Scholar. The quality of each included CPG was appraised by three independent appraisers using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument. Results Six CPGs were critically reviewed. The AGREE II standardized domain scores revealed variation between the quality of these CPGs with the National Institute of Health and Care Excellence (NICE), University of Michigan Health System, and American Academy of Pediatrics CPGs as the top three. Overall, the recommendations for management of ADHD were similar in these CPGs. Conclusions Reporting of CPG development is often poorly documented. Guideline development groups should aim to follow the AGREE II criteria to improve the standards and quality of CPGs. The NICE CPG showed the best quality. Embedding the AGREE II appraisal of CPGs in the training and education of healthcare providers is recommended. The protocol for this study was published in PROSPERO (International prospective register of systematic reviews). Link: http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017078712 and is additionally available from protocols.io. Link: https://dx.doi.org/10.17504/protocols.io.q27dyhn .

Background and objectivesIn Saudi Arabia, people have easy access to medication and can purchase prescribed medications, such as anti-acne medications and antibiotics, over the counter without the need for a prescription from a physician.Our research is focused on estimating the prevalence of self-medication and understanding the reason for self-medication because previous studies have shown an increase in the practice of self-medication globally and locally.The aim of this study is to estimate the prevalence of self-medication among adolescents aged 13–18 years of both genders in Riyadh, Saudi Arabia. In addition, we aim to identify the indications and external and internal factors behind self-medication, including the effects of gender, peer influence and parental supervision on the decision of adolescents to self-medicate.Patients and MethodsAn observational and cross-sectional adolescent-based study was performed to estimate the degree of self-medication among 400 intermediate and high school students in private and governmental schools living in Riyadh between 2014 and 2015 using a multistage random sampling technique. A validated self-administered questionnaire was used for data collection, and data were tabulated and analyzed with the SPSS version 21 computer program.ResultsWe found that the rate of self-medication among adolescents was high (94.5%). Analgesics were the most common medication used (87.3%), and the least common medication used was hormones (5%). A majority of the students reported that headache was the reason for using analgesics. The sources of the medications included the pharmacy (51.64%), followed by parents (34.33%). The results showed that self-medication was significantly associated with the type of school that the adolescents attended (P < 0.011) and the health status of the adolescents (P -value <0.035).ConclusionSelf-medication is highly prevalent in Riyadh, particularly among adolescents. Easy access to pharmacies was found to be the leading cause for self-medication. The use of these drugs was associated with inappropriate drug use and the deterioration of health status. Self-medication should be closely monitored and awareness should be increased with educational programs among students.