Article type
Year
Abstract
Background: non-pharmacological approaches to treat depression include complementary and alternative medicine such as acupuncture. However, clinical practice guidelines (CPGs) tend to give inconsistent recommendations in this regard.
Objective: the aim of this study was to describe the recommendations regarding acupuncture issued in CPGs for depression in adults, and to assess the methodology used to reach them.
Methods: we performed a scoping review of CPGs for depression in adults, which were published or totally/partially updated during January 2014 to May 2018. We included those CPGs that claimed to perform systematic reviews of the evidence, assessed the use of acupuncture as a review question, and were available in English or Spanish. Two authors selected the CPGs and extracted data of interest independently. Variables of interest, besides CPGs' characteristics, included the assessment of the quality of the systematic reviews performed using the AMSTAR-2 (A Measurement Tool to Assess systematic Reviews-2) and details on how the recommendation regarding acupuncture was reached.
Results: we found five CPGs for depression in adults that fulfilled our inclusion criteria: three from USA, one from Canada, and one from China. Regarding the systematic reviews performed by each CPG, most of them failed to adequately report methods such as the search strategy used, the inclusion and exclusion criteria, and the 'Risk of bias' assessment. When evaluating the recommendations regarding acupuncture, two CPGs did not formulate any, two recommended in favour, and one recommended against its use. When analyzing the issued recommendations, the papers cited, the methodology used to reach recommendations, and the consideration of feasibility and resource use were heterogeneous. In addition, the arguments to reach recommendations were not clear in most of the CPGs.
Conclusions: CPGs issue heterogeneous recommendations regarding the usage of acupuncture as a treatment for depression. The heterogeneity in the studies mentioned in each CPG, along with the lack of clarity in the process followed to formulate the recommendations, prevents CPG users to understand how the recommendations were reached, and therefore to adopt or adapt them for local contexts.
Patient or healthcare consumer involvement: this study is of interest to decision makers, who could better understand where the recommendations are issued and therefore decide which CPG to follow.
Objective: the aim of this study was to describe the recommendations regarding acupuncture issued in CPGs for depression in adults, and to assess the methodology used to reach them.
Methods: we performed a scoping review of CPGs for depression in adults, which were published or totally/partially updated during January 2014 to May 2018. We included those CPGs that claimed to perform systematic reviews of the evidence, assessed the use of acupuncture as a review question, and were available in English or Spanish. Two authors selected the CPGs and extracted data of interest independently. Variables of interest, besides CPGs' characteristics, included the assessment of the quality of the systematic reviews performed using the AMSTAR-2 (A Measurement Tool to Assess systematic Reviews-2) and details on how the recommendation regarding acupuncture was reached.
Results: we found five CPGs for depression in adults that fulfilled our inclusion criteria: three from USA, one from Canada, and one from China. Regarding the systematic reviews performed by each CPG, most of them failed to adequately report methods such as the search strategy used, the inclusion and exclusion criteria, and the 'Risk of bias' assessment. When evaluating the recommendations regarding acupuncture, two CPGs did not formulate any, two recommended in favour, and one recommended against its use. When analyzing the issued recommendations, the papers cited, the methodology used to reach recommendations, and the consideration of feasibility and resource use were heterogeneous. In addition, the arguments to reach recommendations were not clear in most of the CPGs.
Conclusions: CPGs issue heterogeneous recommendations regarding the usage of acupuncture as a treatment for depression. The heterogeneity in the studies mentioned in each CPG, along with the lack of clarity in the process followed to formulate the recommendations, prevents CPG users to understand how the recommendations were reached, and therefore to adopt or adapt them for local contexts.
Patient or healthcare consumer involvement: this study is of interest to decision makers, who could better understand where the recommendations are issued and therefore decide which CPG to follow.
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