Article type
Abstract
Background: Jordan's national STEPwise survey for non-communicable diseases in 2019 highlighted a high prevalence of diabetes (20%) among adults aged 45–69 years old, which is among the highest regionally. In response, the Ministry of Health (MOH) identified optimizing diabetes and cardiovascular disease management in primary health care settings as a national public health priority, necessitating evidence-based practice guidelines.
Objectives: We aim to summarize the Jordan diabetes national guidelines experience using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE)-Adolopment framework.
Methods: The MOH convened a national guideline development group which included a core working group (WG) and panel members. A multidisciplinary guideline core WG including clinicians, pharmacists, and a methodologist, collaborated to develop guidelines that are applicable to the Jordanian context. Guideline panelists represented physicians from private and public sectors and a patient representative. The WG searched the literature and identified most recent diabetes guidelines and systematic reviews using the GRADE methodology. The core WG received training about GRADE and the adolopment process from GRADE experts in the Iberoamerican Cochrane Centre and the US GRADE network.
Findings: Out of nine guidelines and reviews identified, the WG included four. The adolopment process commenced in October 2023, with ongoing progress. The WG extracted a list of 29 potential questions from the source guidelines. Panel discussions prioritized therapeutic interventions, resulting in the identification of 15 questions. The GRADE evidence-to-decision framework guides the adolopment process. The core WG conducted targeted searched especially about baseline risks, resource requirements, equity, acceptability, and feasibility considerations to contextualize the evidence to Jordan. The WG is in the process of analyzing data about barriers and facilitators of GRADE-adolopment in Jordan.
Conclusions: In agreement with the premise of “Global evidence, local guidelines”, the establishment of the first national task-force in Jordan to develop guidelines using the GRADE-adolopment approach, marks a significant step toward evidence-based practice in the country. This early experience not only lays the groundwork for the ongoing evolution of diabetes management guidelines but also contributes to building local expertise in evidence-based recommendation synthesis. It also serves as an case example to GRADE-adolopment in Low- and Middle- Income Countries.
Objectives: We aim to summarize the Jordan diabetes national guidelines experience using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE)-Adolopment framework.
Methods: The MOH convened a national guideline development group which included a core working group (WG) and panel members. A multidisciplinary guideline core WG including clinicians, pharmacists, and a methodologist, collaborated to develop guidelines that are applicable to the Jordanian context. Guideline panelists represented physicians from private and public sectors and a patient representative. The WG searched the literature and identified most recent diabetes guidelines and systematic reviews using the GRADE methodology. The core WG received training about GRADE and the adolopment process from GRADE experts in the Iberoamerican Cochrane Centre and the US GRADE network.
Findings: Out of nine guidelines and reviews identified, the WG included four. The adolopment process commenced in October 2023, with ongoing progress. The WG extracted a list of 29 potential questions from the source guidelines. Panel discussions prioritized therapeutic interventions, resulting in the identification of 15 questions. The GRADE evidence-to-decision framework guides the adolopment process. The core WG conducted targeted searched especially about baseline risks, resource requirements, equity, acceptability, and feasibility considerations to contextualize the evidence to Jordan. The WG is in the process of analyzing data about barriers and facilitators of GRADE-adolopment in Jordan.
Conclusions: In agreement with the premise of “Global evidence, local guidelines”, the establishment of the first national task-force in Jordan to develop guidelines using the GRADE-adolopment approach, marks a significant step toward evidence-based practice in the country. This early experience not only lays the groundwork for the ongoing evolution of diabetes management guidelines but also contributes to building local expertise in evidence-based recommendation synthesis. It also serves as an case example to GRADE-adolopment in Low- and Middle- Income Countries.