Resumen
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.
| Título traducido de la contribución | Development and implementation of guidelines for the management of depression: A systematic review |
|---|---|
| Idioma original | Spanish |
| Páginas (desde-hasta) | 683-697H |
| Publicación | Bulletin of the World Health Organization |
| Volumen | 98 |
| N.º | 10 |
| DOI | |
| Estado | Published - oct. 2020 |
Nota bibliográfica
Funding Information:Competing interests: Author YL received salary support from the Global Alliance for Chronic Diseases, Canadian Institutes of Health Research (CIHR), and National Natural Science Foundation of China’s Mental Health Team Grant and the CIHR Frederick Banting and Charles Best Canada Graduate Scholarship. Author EB reports personal fees from Dai-ichi Sankyo, grants from CAPES, CNPq, FAPESP, Queen's University Establishment Grant, and Southeastern Ontario Academic Medical Association Innovation Grant outside the submitted work. Author CB was involved as panel member and methodologist in the development of the WHO mhGAP guidelines for the management of mental health conditions in low-and middle-income countries. Author OL reports FRSQ salary award
Funding Information:
252872. Author MV reports personal fees from Lundbeck Pharma, Sunovion and Janssen/Cilag outside the submitted work within the last three years. Author MS reports personal fees from Lundbeck A/S and Sumitomo Dainippon Pharma outside the submitted work. Author RJP reports other fees from CBT-pro, Lundbeck, and Servier Australia outside the submitted work. Author RSM reports research grant support from Global Alliance for Chronic Diseases, Canadian Institutes of Health Research (CIHR) and National Natural Science Foundation of China’s Mental Health Team Grant; speaker/consultation fees from Lundbeck, Janssen, Purdue, Pfizer, Otsuka, Allergan, Takeda, Neurocrine, Sunovion, Minerva, Intra-Cellular, Ab-bvie outside the submitted work; and is a shareholder and CEO of Champignon Brands. Author VB-M reports grants and personal fees from Angelini Spain, Bristol-Myers-Squibb, Ferrer, Janssen, Lundbeck, Nutricion Medica and Ot-suka. Author WAN reports personal fees from Daleco Pharma and Aristo Pharma outside the submitted work. Author MA reports personal fees from Lundbeck, Newbridge, Janssen and Pfizer outside the submitted work. Author JDR has received research grant support from the Canadian Cancer Society, Canadian Psychiatric Association, American Psychiatric Association, American Society of Psychopharmacology, University of Toronto, University Health Network Centre for Mental Health, Joseph M. West Family Memorial Fund and Time-posters Fellowship and industry funding for speaker/consultation/research fees from Janssen, Allergan, Lundbeck, Sun-ovion and COMPASS. He is the medical director of a private clinic providing intravenous ketamine infusions and intranasal esketamine for depression. Author RWL reports personal fees or research funds from Akili, Allergan, Asia-Pacific Economic Cooperation, BC Leading Edge Foundation, Canadian Institutes of Health Research, Canadian Network for Mood and Anxiety Treatments, Canadian Psychiatric Association, CME Institute, Hansoh, Healthy Minds Canada, Janssen, Lundbeck, Lundbeck Institute, Medscape, MITACS, Ontario Brain Institute, Otsuka, Pfizer, St. Jude Medical, University Health Network Foundation and VGH-UBCH Foundation outside the submitted work.
Publisher Copyright:
© 2020, World Health Organization. All rights reserved.
ASJC Scopus Subject Areas
- Public Health, Environmental and Occupational Health
ODS de las Naciones Unidas
Este resultado contribuye a los siguientes Objetivos de Desarrollo Sostenible
