Development and implementation of guidelines for the management of depression: a systematic review

Abstract

Objective To evaluate the development and implementation of clinical practice guidelines for the management of depression globally. Methods We conducted a systematic review of existing guidelines for the management of depression in adults with major depressive or bipolar disorder. For each identified guideline, we assessed compliance with measures of guideline development quality (such as transparency in guideline development processes and funding, multidisciplinary author group composition, systematic review of comparative efficacy research) and implementation (such as quality indicators). We compared guidelines from low- and middle-income countries with those from high-income countries. Findings We identified 82 national and 13 international clinical practice guidelines from 83 countries in 27 languages. Guideline development processes and funding sources were explicitly specified in a smaller proportion of guidelines from low- and middle-income countries (8/29; 28%) relative to high-income countries (35/58; 60%). Fewer guidelines (2/29; 7%) from low- and middle-income countries, relative to high-income countries (22/58; 38%), were authored by a multidisciplinary development group. A systematic review of comparative effectiveness was conducted in 31% (9/29) of low- and middle-income country guidelines versus 71% (41/58) of high-income country guidelines. Only 10% (3/29) of low- and middle-income country and 19% (11/58) of high-income country guidelines described plans to assess quality indicators or recommendation adherence. Conclusion Globally, guideline implementation is inadequately planned, reported and measured. Narrowing disparities in the development and implementation of guidelines in low- and middle-income countries is a priority. Future guidelines should present strategies to implement recommendations and measure feasibility, cost–effectiveness and impact on health outcomes.

Screening and treatment of depression – recommendations for Polish health professionals

“…According to the available data, recommendations for the prevention, screening, and treatment of depression have been developed in many countries around the world. The recent review of guidelines for the management of depression identified all national ( n = 82) and international ( n = 13) clinical practice guidelines from around the world [ 28 ]. All these recommendations were developed in the 21 st century and are updated periodically.…”

“…Many studies emphasize the need to develop recommendations in individual countries, taking into account various cultural factors as well as the specificity of the healthcare system in a given country [ 70 ]. A recent review of guidelines for the management of depression summarized all worldwide clinical practice guidelines [ 28 ]. The authors of this review also stressed the importance of considering the strategies to implement recommendations in given countries.…”

The Tuberculosis-Depression Syndemic and Evolution of Pharmaceutical Therapeutics: From Ancient Times to the Future

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“…Global deaths associated with major depression were estimated in excess of 2.2 million in 2010 (6), with a 20-fold greater suicide risk than the general population (4). Unlike tuberculosis (1), comprehensive management policies for depression are not universally available (7).…”

Association between declines in objective masticatory performance and salivary stress markers: The Suita study

“…In modern society, stress has become a significant problem that warrants evaluation and management 1 . Dentists frequently encounter patients who suffer psychological and social stress as a result of not being able to masticate effectively 2 .…”