Characteristics and quality of clinical practice guidelines for depression in adults: a scoping review

Abstract

Background Clinical Practice Guidelines (CPGs) should follow an adequate methodology using an evidence-based approach in order to provide reliable recommendations. However, little is known regarding the quality of CPGs for Depression, which precludes its adequate use by stakeholders and mental health professionals. Thus, the aim of this study was to conduct a scoping review to describe the characteristics and quality of CPGs for Depression in adults. Methods We searched CPGs for Depression in adults in eighteen databases. We included those that were published in English or Spanish between January 2014 and May 2018 and were based on systematic reviews of the evidence. Two independent authors extracted the characteristics, type and number of recommendations, and quality (using the Appraisal of Guidelines for Research and Evaluation-II [AGREE-II]) of each included CPG. Results We included eleven CPGs, of which 9/11 did not include the participation of patients in the development of the CPG, 4/11 CPGs had a score ≥ 70% in the overall evaluation of AGREE-II, and 3/11 CPGs had a score ≥ 70% in its third domain (rigor of development). In addition, only 5/11 CPGs shared their search strategy, while only 4/11 listed the selected studies they used to reach recommendations, and 7/11 CPGs did not clearly state which methodology they used to translate evidence into a recommendation. Conclusions Most of evaluated CPGs did not take into account the patient’s viewpoints, achieved a low score in the rigor of development domain, and did not clearly state the process used to reach the recommendations. Stakeholders, CPCGs developers, and CPGs users should take this into account when choosing CPGs, and interpreting and putting into practice their issued recommendations. Electronic supplementary material The online version of this article (10.1186/s12888-019-2057-z) contains supplementary material, which is available to authorized users.

Complementary and alternative medicine recommendations for depression: a systematic review and assessment of clinical practice guidelines

“…One such study that appraised 17 guidelines on low back pain for both overall and CAM sections, determined that the highest ranking domain was scope and purpose (88.6% overall, 87.1% CAM), followed by clarity of presentation (83.0% overall, 73.2% CAM), and the lowest ranking domain was applicability (31.8, 21.8%), similar to this study's findings [72]. Likewise, other similar studies appraising guidelines of various conditions [25][26][27][71][72][73][74][75][76][77][78][79], including the recent study that appraised 11 guidelines on depression in adults [25], had results similar to this review, demonstrating that the variable and sub-optimal quality of guidelines is consistent with the literature and is not unique.…”

“…Moreover, evidence-based guidelines contain therapy recommendations that are typically relied upon by healthcare professionals to understand their risks and benefits, and they thereby lend to informed and shared decision-making with patients [ 23 , 24 ]. To our knowledge, there are only three studies in the literature that have previously assessed the quality of depression guidelines in general with different scopes and methods [ 25 – 27 ]; one study assessed the overall guidelines for depression in adults [ 25 ], one study assessed the guidelines for the management of depression in primary care in general [ 26 ], and one study assessed guidelines for both depression and anxiety in children and youth [ 27 ]. No studies have previously assessed the CAM recommendations in guidelines for the treatment and/or management of depression in adults.…”

Trends in the prevalence and treatment of depressive symptoms in Peru: a population-based study

“…Finally, in order for a clinical practice guideline to be successfully implemented and accepted by the patients, they should be involved in the development of these guidelines. 52 …”

“…Finally, in order for a clinical practice guideline to be successfully implemented and accepted by the patients, they should be involved in the development of these guidelines. 52 Strengths and limitations The present study includes the analysis of five measurements from different years of information collected from nationally representative surveys in the Peruvian population . This is the first study assessing the trends of depressive symptoms in Peru.…”

Efficacy and effectiveness studies of depression are not well-differentiated in the literature: a systematic review

“…Clinical practice guidelines (CPGs) recommend treatment with antidepressant medications, psychotherapies and other modalities. However, depression CPGs have been criticised for their low validity, poor generalisability and limitations in their implementation 2–4. These criticisms stem in part from over-reliance on the results of published randomised controlled trials (RCTs) 5 6.…”