What are the characteristics of clinical practice guidelines for the treatment of depression?

Article type
Authors
Santos NCL1, Molino CDGRC1, Gabriel FC1, Vieiro MM2, Ribeiro E1, Romano-Lieber NS3, Melo DO2
1Faculty of Pharmaceutical Sciences, University of Sao Paulo
2Institute of Environmental Sciences, Chemical and Pharmaceutical, Federal University of São Paulo
3School of Public Health, University of Sao Paulo
Abstract
Background: Clinical practice guidelines (CPGs) are essential tools to guide health professionals to deliver evidence-based interventions.

Objectives: To describe the characteristics of CPGs that recommend pharmacological treatment for depression.

Methods: We conducted a systematic review of 12 specific databases for CPGs. Inclusion criteria were CPGs for the treatment of depression in primary care and that comprised pharmacological recommendations for the adult or elderly, written in English, Portuguese or Spanish, and published between 2011 and 2016. CPGs designed for local use or for a specific population were excluded. Two reviewers screened CPGs for eligibility. Data extraction was performed independently by 2 reviewers. Discrepancies at any stage were resolved by consensus between the 2 reviewers. A third reviewer was involved when needed.

Results: A total of 38 records were identified, of which 15 were eligible for this study. Table 1 describes the extracted data and Table 2 summarises these data. More than half of CPGs were from North America (53%), had the health care professionals as target users (73%), performed a systematic review (80%), did not stated clearly the method to formulate the recommendations (60%), used other method than GRADE to classify the recommendations (53%), and was funded (87%). Moreover, 9 (60%) CPGs were updated version, of which 5 CPGs did not mention the updated period and 4 CPGs were published in 2013 or before. None CPGs had mentioned patients as the target user.

Conclusions: Our data suggest that CPGs presented high rigour to search and select evidence to support the recommendations. However, CPGs developers should improve the statement to formulate the recommendations and adopt the GRADE system to classify the recommendations.